Pigeon circovirus infection (PiCV) was diagnosed by light and transmission electron microscopy in 15 birds from five lofts in western France. Histopathological findings were suggestive of primary bursotropism of pigeon circovirus, followed by secondary systemic spread from the bursa of Fabricius, particularly to non-bursal lymphoid organs. The last stage of the disease was associated with various secondary (particularly bacterial) infections. In situ detection of apoptosis in the bursa of Fabricius indicated that PiCV was concomitant with an increase in bursal lymphocytic apoptotic events related to viral infection and leading to severe acquired immunosuppression.

In a case of a neglected radial neck fracture in childhood, the management of initial fracture and its complications are subjected to discussion. In children, open reduction should be avoided but an angulation less than 30° must be obtained. Several techniques exist to manage symptomatic malunion in adults, including resection, prosthesis, and osteotomy. When performing an osteotomy, it is important first to preserve an intact osseous hinge to avoid avascular necrosis and second to align the edge of the radial head articular surface with the lateral edge of the coronoid process, in order to avoid overstuffing elbow joint.

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Twenty-seven patients with metastatic adenocarcinoma of the breast refractory to other chemotherapy were treated with mitomycin-C plus metronidazole. The mitomycin-C dose was 15-20 mg/m2 I.V. repeated every 6-9 weeks. Metronidazole 1.5 g/m2 was given p.o. 12 hr and 1 hr before mitomycin-C and again 6 hr and 24 hr after mitomycin-C. Partial remissions were noted in 4 of 24 (17%) evaluable patients. Good performance status patients who were lightly pretreated, unresponsive to prior chemotherapy, and estrogen receptor negative were most likely to respond, and further studies are indicated in this subgroup of patients. Hematological toxicity was similar to that anticipated with mitomycin-C alone. Gastrointestinal toxicity was probably increased. Three probable and 2 possible cases of pulmonary toxicity were seen. It is unclear whether the incidence of mitomycin-C pulmonary toxicity was increased by the metronidazole.

A radionuclide technique was developed to obtain reproducible measurements of cerebrospinal fluid flow in Rickham-Holter type shunt systems. In attempting to reproduce previously described radionuclide procedures, we found that different flow rate measurements can be obtained simply by changing the radiotracer injection technique or the method of analysis of the time activity curves which are generated. The importance of these technical pitfalls cannot be over-emphasized, since there is no gold standard to evaluate cerebrospinal fluid flow in vivo. An experimental model with a calibrated Harvard pump and a shunt system filled with normal saline was constructed. Aliquots of 500 microCi of pertechnetate in 0.05 ml of saline were injected serially into the center of Rickham reservoir using a size 28 needle. Time-activity curves were obtained after waiting five min to reach equilibrium, and standard curves of radiotracer clearance vs actual flow for each system used clinically in our institution were generated. In addition, a technique to quantify and thus correct for the small but significant leak of radiotracer which occurs at the site of injection in the reservoir is described. Excellent correlation was obtained between our results and the clinical and radiological findings in a preliminary clinical evaluation.

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