This article focuses on human Borna disease virus (BDV) infections, most notably on the development of valid diagnostic systems, which have arisen as a major research issue in the past decade. The significance of a novel modular triple enzyme-linked immunosorbent assay that is capable of specifically measuring anti-BDV antibodies as well as major structural proteins N (p40) and P (p24) in the blood, either as free antigens in the plasma or as antibody-bound circulating immune complexes (CICs), is explained. The impact of CICs and plasma antigen, which indicate periods of antigenemia in the course of BDV infection, along with other infection markers that are still in use is discussed. The review further provides new insight into possible links of BDV to human diseases, summarizing cross-sectional and longitudinal data which correlate acute depression with the presence and amount of antigen and CICs. Moreover, BDV prevalence in healthy people is reevaluated, suggesting that this was previously underestimated. Antiviral efficacy of amantadine, in vivo and in vitro, is outlined as well, with emphasis on wild-type (human and equine) versus laboratory strains. Finally, the pros and cons of the association of BDV with human disease, as detailed in the literature, are critically discussed and related to our data and concepts. This article supports existing correlative evidence for a pathogenic role of BDV infection in particular human mental disorders, in analogy to what has been proven for a variety of animal species

Cerebral perfusion pressure is commonly calculated from the difference between mean arterial pressure and intracranial pressure because intracranial pressure is known to represent the effective downstream pressure of the cerebral circulation. Studies of other organs, however, have shown that effective downstream pressure is determined by a critical closing pressure located at the arteriolar level. This study was designed to investigate the effects of PCO2-induced variations in cerebrovascular tone on the effective downstream pressure of the cerebral circulation. Sixteen patients recovering from head injury were studied. Intracranial pressure was assessed by epidural pressure transducers. Blood flow velocity in the middle cerebral artery was monitored by transcranial Doppler sonography. Effective downstream pressure was derived from the zero flow pressure as extrapolated by regression analysis of instantaneous arterial pressure/middle cerebral artery flow velocity relationships. PaCO2 was varied between 30 and 47 mm Hg in randomized sequence. Intracranial pressure decreased from 18.5+/-5.2 mm Hg during hypercapnia to 9.9+/-3.1 mm Hg during hypocapnia. In contrast, effective downstream pressure increased from 13.7+/-9.6 mm Hg to 23.4+/-8.6 mm Hg and exceeded intracranial pressure at hypocapnic PaCO2 levels. Our results demonstrate that, in the absence of intracranial hypertension, intracranial pressure does not necessarily represent the effective downstream pressure of the cerebral circulation. Instead, the tone of cerebral resistance vessels seems to determine effective downstream pressure. This suggests a modified model of the cerebral circulation based on the existence of two Starling resistors in a series connection.

Twenty-two hysterectomy specimens were collected over a period of two decades in order to investigate the morphological sequence of menstrual desquamation and its consecutive remodeling of the endometrium. The technique used was described earlier by H. Ludwig and H. Metzger (1976). Scanning electron microscopy is the only way to illustrate and describe the microarchitecture of the endometrial surface. At the beginning of the menstrual bleeding, glandular stumps surviving the desquamation of the layer functionalis stick out from the debris at the top of the basal layer. Fibrin mesh formation, the liberation of lysosomes, and the emigration of white blood cells and macrophages, both being already present in the midluteal endometrial stroma, can be observed. They are interrelated with the clearance of the menstrual wound. Coincidentally with the process of desquamation the re-epithelization starts and takes the first four to six days of the normal cycle. The events are illustrated by selecting specimens of uteri from women with comparable data but from different days of the normal cycle. Surprisingly transitory excess formation of epithelial outgrows (micropolyps) are observed. They disappear later in the cycle, some might persist and form micropolyps, which will be the source of occasional intermenstrual bleeding--so far the polyps are vascularized. The endometrial surface is covered de novo by a lining surface epithelium at the sixth day. Ciliogenesis occurs within this epithelium. Other ciliated cells emanate from the glandular epithelium. In early stages of menstrual regeneration the growth pattern of the epithelial monolayer forming the lining surface in spiral traces according to their origination from the circle-structures of the endometrial glands. Before the incoming menstrual break-down small crevices, clefts or defects appear within the lining surface endometrium, a few white blood cells, enriched in the stroma around the vessels, might even reach the surface. The apical membranes of several non-ciliated cells exhibit rounded leaks, others show ruptures. It is the tissue break-down around the superficial endometrial vessels, what creates the onset of menstrual blood flow. In the very early preparations of the bleeding endometrium those opened capillary vessels could be identified.

The present preliminary report (comprising illustrative case reports) demonstrates and introduces for the first time the utility of piezoelectric bone surgery in cranial base and spinal surgery in children. Until now, there has been no documented neurosurgical experience of this technique even in adults.

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