1 provides support for our ongoing work on the role of the muscle and the participation of the poliovirus receptor in the transport of the poliovirus from the muscle to the motor neurons. The poliovirus receptor, an integral membrane protein with structural characteristics of the immunoglobulin superfamily of proteins, 2 is the prerequisite for infection of tissue with the poliovirus. The possible entry of the virus into the central nervous system through muscle prompted us to search for the poliovirus receptor in normal human muscle fibers and motor end plates and in degenerating muscle fibers.Using an immunoperoxidase technique with a specific monoclonal antibody against the poliovirus receptor, 2 we found that the receptor, although not expressed in normal human muscle fibers, is rapidly up-regulated in muscle fibers undergoing degeneration 3 ( Fig. 1A and 1B, facing page). Muscle fibers can be expected to degenerate as a result of injury from intramuscular injections. A double-labeled technique involving the use of rhodamine-conjugated a -bungarotoxin, which binds to the end plates, and mouse IgG antibodies to the poliovirus receptor followed by fluorescein-conjugated goat antimouse IgG showed the presence of the poliovirus receptors in the end-plate region of the normal human muscle ( Fig. 1C and 1D). The presence of poliovirus receptors in these locations explains the mechanism of provocation paralysis after intramuscular injections. The viremia that follows digestion of the oral poliovirus vaccine and the absence of a blood-nerve barrier at the neuromuscular junction allow the virus to enter and bind to certain motor end plates bearing poliovirus receptors. The injury of muscle fibers induced by multiple intramuscular injections subsequently exposes the degenerating muscle fibers that express poliovirus receptors to the virus. The poliovirus, which can replicate rapidly in human muscle in vitro, 3,4 may travel transynaptically from the end-plate region to the intramuscular nerve terminals and, by retrograde transport, to the regional motor neurons. Because the expression of poliovirus receptors in muscle is up-regulated during viral infections, 4 the provocation paralysis reported by Strebel et al. may have been facilitated by the underlying infectious illness, for which nearly all the children received intramuscular injections with antibiotic agents. 1 Among other viruses, the rabies virus can also travel to the central nervous system through the muscle, by binding to the nicotinic acetylcholine receptor at the neuromuscular junction. 5 M Instructions for Letters to the EditorLetters to the Editor are considered for publication (subject to editing and abridgment) provided they do not contain material that has been submitted or published elsewhere. Please note the following:• Your letter must be typewritten and triple-spaced.• Its text, not including references, must not exceed 400 words (please include a word count).• It must have no more than five references and one figure or table.• It should not ...

Intensive use of the lotion doubles the likelihood that breast cancer patients will not develop radiodermatitis during radiotherapy. Furthermore, compared with standard use, intensive use is more effective in reducing the incidence of skin toxicity and skin toxicity grade 2 or higher.

No abstract

No abstract

The presentation of scalp metastases from leiomyosarcoma of the vena cava is an extremely infrequent event. There are no other publications that describe such finding and very few of leiomyosarcoma in vessels. About this event we have reviewed the English literature describing studies on scalp metastases and skin metastases in general: their incidence, origin, clinical appearance, meaning, and diagnosis. The case we describe would be the second one presented worldwide because, as far as we know, it has been only one more published in 2005.