Herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) establish latency and express the latency-associated transcript (LAT) preferentially in different murine sensory neuron populations, with most HSV-1 LAT expression in A5؉ neurons and most HSV-2 LAT expression in KH10 ؉ neurons. To study the mechanisms regulating the establishment of HSV latency in specific subtypes of neurons, cultured dissociated adult murine trigeminal ganglion (TG) neurons were assessed for relative permissiveness for productive infection. In contrast to that for neonatal TG, the relative distribution of A5 ؉ and KH10 ؉ neurons in cultured adult TG was similar to that seen in vivo. Productive infection with HSV was restricted, and only 45% of cultured neurons could be productively infected with either HSV-1 or HSV-2. A5؉ neurons supported productive infection with HSV-2 but were selectively nonpermissive for productive infection with HSV-1, a phenomenon that was not due to restricted viral entry or DNA uncoating, since HSV-1 expressing ␤-galactosidase under the control of the neurofilament promoter was detected in ϳ90% of cultured neurons, with no preference for any neuronal subtype. Infection with HSV-1 reporter viruses expressing enhanced green fluorescent protein (EGFP) from immediate early (IE), early, and late gene promoters indicated that the block to productive infection occurred before IE gene expression. Trichostatin A treatment of quiescently infected neurons induced productive infection preferentially from non-A5 ؉ neurons, demonstrating that the nonpermissive neuronal subtype is also nonpermissive for reactivation. Thus, HSV-1 is capable of entering the majority of sensory neurons in vitro; productive infection occurs within a subset of these neurons; and this differential distribution of productive infection is determined at or before the expression of the viral IE genes.Herpes simplex virus 1 and 2 (HSV-1 and HSV-2) replication at the periphery is accompanied by infection of neuronal axons and subsequent retrograde axonal transport to cell bodies of primary sensory neurons, where infection may follow either a productive or a latent pathway. For some neurons, lytic gene expression and progeny virus production are thought to result in cell death, while in other neurons, the productive cycle fails and the virus establishes a latent infection. The factors that determine whether HSV progresses through a productive cycle or establishes latency are not clear. It is suspected that different neuronal subtypes and/or the presence or absence of certain host factors may be critical in determining the outcome of infection.Primary sensory neurons are a diverse population of cells that are classified according to cellular morphology, physiological response properties, and patterns of gene expression. We have demonstrated previously that HSV-1 and HSV-2 preferentially establish latency and express the latency-associated transcript (LAT) in different populations of neurons, identified by the A5 and KH10 markers, within sensory ganglia (21,28,52). ...

Acute colonic diverticulitis is a gastrointestinal condition frequently encountered by primary care practitioners, hospitalists, surgeons, and gastroenterologists. Clinical presentation ranges from mild abdominal pain to peritonitis with sepsis. It can often be diagnosed on the basis of clinical features alone, but imaging is necessary in more severe presentations to rule out such complications as abscess and perforation. Treatment depends on the severity of the presentation, presence of complications, and underlying comorbid conditions. Medical and surgical treatment algorithms are evolving. This article provides an evidence-based, clinically relevant overview of the epidemiology, diagnosis, and treatment of acute diverticulitis.

The advent of RFs was associated with a threefold increase in vena cava filter placement in our trauma center. Major FRCs were encountered and a very low incidence of PE was not altered by their use. Successful removal could be verified in only 21% of RFs. The results of this study lead us to question the rationale for a more liberal use of vena cava filters in trauma patients.