Long-term Impact of Intrauterine MCMV Infection on Development of Offspring Nervous System

This study examined the impacts of intrauterine murine cytomegalovirus（MCMV） infection on the long-term learning and memory of offspring.Sexually matured male and female BALB/C mice without MCMV infection were identified by ELISA and then mated.Seventy pregnant mice were randomly divided into the virus group（n=40） and the control group（n=30）,in which the pregnant mice were subjected to placenta inoculation of MCMV suspension（1 μL,1×106 PFU） or the same amount of cell culture medium,respectively,at gestational age of 12.5 days.Some pregnant mice [virus group（n=20）,control group（n=15）] were sacrificed by cervical dislocation at gestational age of 18.5 days,and the head circumference and brain weight of the mouse fetuses were measured,and the MCMV infection in their brain tissues was detected by PCR.The other pregnant mice [virus group（n=20）,control group（n=15）] delivered naturally,and the learning and memory capability of the offspring at 70-day-old was analyzed by Morris water maze test.The results showed that 28.57% mouse fetuses in the virus group developed viral infection in the brain.Their head circumference and brain weight were significantly reduced as compared with those in the control group（P0.01）.The Morris water maze test revealed that the mouse offspring in the control group found the platform with straight-line trajectories after training.In contrast,the counterparts in the virus group intended to enter the central area,but looked for the platform with a circular trajectory.And the infected mice exhibited prolonged swimming distance and swimming latency（P0.01）.It was concluded that：（1） placenta inoculation of MCMV can cause fetal brain infection and intrauterine development retardation;（2） the offspring of MCMV placenta inoculation mice showed a long-term decline in learning and memory capability.

A Study on the Traditional Chinese Medicine Jinyebaidu for Prevention and Treatment of Intrauterine Infection with Guinea Pigs Cytomegalovirus

The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine （TCM）-Jinyebaidu （JYBD） to guinea pig cytomegalovirus （GPCMV） intrauterine infection. The virus-free female and male guinea pigs were screened with nest-polymerase chain reaction （N-PCR）. After inbred, pregnant guinea pigs were selected and divided into 3 groups randomly： 5 guniea pigs of the blank control group were not given either GPCMV or JYBD. 31 guniea pigs of the positive control group were inoculated 1 mL （107 TCID50 ） suspension of GPCMV intraperitoneal. 10 gunlea pigs of the experimental group were inoculated GPCMV firstly and then perfused stomach with JYBD for 14 days （Dosage in accordance with the modulus of the weight ratio of human to guniea pig）. The effects of JYBD on the intrauterine infection of GPCMV were observed. The results showed that JYBD could decrease the maternal infection rate from 100 % （31/31） to 50 % （5/10） （P〈0. 001）, the intrauterine infection rate from 100% （72/72） to 75 % （21/28） （P〈 0. 001）, and the rate of abnormal outcome of pregnancy from 64.4 % （29/45） to 25.0 % （7/28） （P〈0. 001）, the infective symptoms being relieved. It can be concluded that traditional Chinese medicine- JYBD can prevent and treat GPCMV intrauterine infection, and can be expected a prophylactic drug for HCMV intrauterine infection.

Protective Effects of Activated Protein C on Neurovascular Unit in a Rat Model of Intrauterine Infection-Induced Neonatal White Matter Injury

Summary： Activated protein C （APC）, a natural anticoagulant, has been reported to exert direct vascu- loprotective, neural protective, anti-inflammatory, and proneurogenic activities in the central nervous system. This study was aimed to explore the neuroprotective effects and potential mechanisms of APC on the neurovascular unit of neonatal rats with intrauterine infection-induced white matter injury. In- traperitoneal injection of 300 ~tg/kg lipopolysaccharide （LPS） was administered consecutively to preg- nant Sprague-Dawley rats at embryonic days 19 and 20 to establish the rat model of intrauterine infec- tion-induced white matter injury. Control rats were injected with an equivalent amount of sterile saline on the same time. APC at the dosage of 0.2 mg/kg was intraperitoneally injected to neonatal rats imme- diately after birth. Brain tissues were collected at postnatal day 7 and stained with hematoxylin and eo- sin （H＆E）. Immunohistochemistry was used to evaluate myelin basic protein （MBP） expression in the periventricular white matter region. Blood-brain barrier （BBB） permeability and brain water content ~were measured using Evens Blue dye and wet/dry weight method. Double immunofluorescence staining and real-time quantitative PCR were performed to detect microglial activation and the expression of protease activated receptor 1 （PAR1）. Typical pathological changes of white matter injury were ob- served in rat brains exposed to LPS, and MBP expression in the periventricular region was significantly decreased. BBB was disrupted and the brain water content was increased. Microglia were largely acti- vated and the mRNA and protein levels of PAR1 were elevated. APC administration ameliorated the pathological lesions of the white matter and increased MBP expression. BBB permeability and brain water content were reduced. Microglia activation was inhibited and the PAR1 mRNA and protein ex- pression levels were both down-regulated. Our results suggested that APC exerted neuroprotective ef- fects on multiple components of the neurovascular unit in neonatal rats with intrauterine infec- tion-induced white matter injury, and the underlying mechanisms might involve decreased expression of PAR1.

Inhibitory Effect of LPS on the Proliferation of Oligodendrocyte Precursor Cells through the Notch Signaling Pathway inIntrauterine Infection-induced Rats

Periventricular white matter injury (PWMI)is very common in survivors of premature birth,and the final outcomes are a reduction in myelinated neurons leading to white matter hypomyelination.How and (or) why the oligodendrocyte lineage develops abnormally and myelination is reduced is a hot topic in the field.This study focuses on the effect of intrauterine inflammation on the proliferation of oligodendrocyte lineage cells and the underlying mechanisms.Lipopolysaccharide (LPS)(300μg/kg)was intraperitoneally injected into pregnant Sprague-Dawley rats at embryonic days 19 and 20 to establish a rat model of intrauterine infection-induced white matter injury.Corpus callosum tissues were collected at postnatal day 14(P14)to quantify the number of oligodendrocytes,the number and proliferation of oligodendrocyte precursor cells (OPCs), and the expression of myelin proteins (MBP and PLP).Furthermore,the expression of Writ and Notch signaling-related proteins was analyzed.The results showed that the number of oligodendrocytes in the corpus callosum tissues of LPS-treated rats was reduced,and the expression levels of myelinating proteins were down-regulated.Further analysis showed that the Notch signaling pathway was down-regulated in the LPS-treated group.These results indicate that intrauterine LPS may inhibit the proliferation of OPCs by down-regulating the Notch rather than the Writ signaling pathway,leading to hypomyelination of white matter.

Relationship between HBV viremia level of pregnant women and intrauterine infection:neated PCR for detection of HBV DNA

IM To determine the incidence of hepatitis B virus (HBV) intrauterine infection and to explore the relationship between HBV viremia level of pregnant women and HBV intrauterine infection.METHODS Sixtynine pregnant women were divided into three groups. Group A, 41 HBsAg positive patients, 14 of them were HBeAg positive (group A1), and 27 HBeAg negative (group A2); Group B, 12 HBsAg negative patients, but positive for antiHBs and/or antiHBe and/or antiHBc; and Group C, 16 patients negative for all HBV markers. Blood samples of mothers were taken at delivery, samples of their infants were collected within 24 hours after birth (before injection of HBIG and HBV vaccine). All the serum samples were stored at -20℃. HBV serum markers were tested by radioimmunoassay and HBV NDA were detected by nested polymerase chain reaction.RESULTS In group C, all of 16 newborns were negative for HBsAg and HBV DNA. In group A, 7 infants were HBsAg positive (171%), and 17 (415%) were HBV DNA positive (P<005). The incidence of intrauterine HBV infection was much higher in group A1 than that in group A2 (HBsAg 429% vs 37%, HBV DNA 929% vs 148%, P<005). The incidence of HBV intrauterine infection was significantly different between high and low HBV viremia of mothers (933% vs 429%, P<005).CONCLUSION The incidence of HBV intrauterine infection is high when HBV DNA in newborns detected with nested PCR is used as a marker of HBV infection. It is related to HBV viremia level of mothers.

Pneumococcal infection transmission between family members with congenital asplenia: A case report

BACKGROUND Asplenia,the lack of a spleen,can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria,such as Streptococcus pneumoniae(S.pneumoniae).We report two cases of severe pneumococcal infection in two asplenic family members living in the same household.CASE SUMMARY Patient 1,a 38-year-old man with a history of congenital hepatitis B infection and hypospadias,was brought to our emergency department with complaints of cyanosis,cough,and edema of his limbs.He was clinically diagnosed as hyposplenic with overwhelming pneumococcal sepsis.He was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after admission.Patient 2,a 63-year-old woman with a history of type 2 diabetes,was brought to our emergency department one month after admission of Patient 1.She was diagnosed as asplenic with overwhelming pneumococcal sepsis.History-taking revealed that she was the mother of Patient 1 and the two had lived in the same household.She was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after admission.CONCLUSION Pneumococcal bacteremia caused by virulent S.pneumoniae may be transmitted within households.All residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of transmissibility.Family members of patients with congenital asplenia/hyposplenia,all family members should be examined to assess their splenic function.

Congenital Cytomegalovirus Infection and Maternal Varicella during Pregnancy.Is There a Coincidence?A Case Report

Background: Co-infections may represent substantial diagnostic and treatment challenges. Aim: To the better of our knowledge, we describe the first case in the literature of congenital Cytomegalovirus (CMV) infection following maternal CMV non primary infection contemporary to varicella during pregnancy. Case Presentation: A pregnant woman had a varicella during her pregnancy. Congenital CMV infection was fortuitously discovered in the neonate owing to a universal CMV screening. Retrospective analysis of maternal serums during pregnancy showed CMV reactivation. We aim to highlight that CMV reactivation could be due to varicella and discuss if it could facilitate the transplacental transmission of CMV. Conclusion: This case report emphasizes neonatal CMV screening, and warns against dual maternal infection especially because this may be at particular risk of transmission to the fetus.

Effects of intrauterine infection in different periods on the placenta and endometrial blood vessel formation of pregnant mice and the growth and development of fetal rats

Objective:To investigate the effects of intrauterine infection in different periods on the placenta and endometrial blood vessel formation of pregnant rats and the growth and development of fetal rats.Methods:According to the random number table method,32 pregnant rats were divided into the early infection group,the mid-term infection group,the late infection group and the control group,with 8 rats in each group.On the 3rd,9th and 15th day of pregnancy,lipopolysaccharide was injected intraperitoneally to construct intrauterine infection models.The pregnant rats in the control group were intraperitoneally injected with the same dose of 0.9%sodium chloride solution.On the 18th day of pregnancy,the inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-(TNF-)],the blood vessel density of placenta and endometrium in the placental tissues of pregnant rats,dead fetus+absorbed fetus,the inflammatory factors IL-6,TNF-and oxidation reaction indicators[malondialdehyde(MDA)and myeloperoxidase(MPO)]in the fetal rat lung and brain tissues were detected.Results:The changing trend of IL-6 and TNF-levels in the placental tissues of pregnant rats with intrauterine infection in different periods was:the control group<the late infection group<the mid-term infection group<the early infection group,the differences were statistically significant(p<.05).The changing trend of fetal rat weight,placental weight and placental coefficient in the intrauterine infection groups in different periods was:the control group>the late infection group>the mid-term infection group>the early infection group,the differences were statistically significant(p<.05).The blood vessel density of placenta and endometrium,the mean number of fetuses,brain coefficient and lung coefficient in the late infection group were significantly increased in comparison with the early infection group and the mid-term infection group.The total number and the ratio of dead fetus+absorbed fetus,the levels of IL-6,TNF-,MDA and MPO in brain and lung tissues were significantly reduced,and the differences were statistically significant(p<.05).The blood vessel density of placenta and endometrium,brain coefficient and lung coefficient of pregnant rats in the mid-term infection group were significantly increased in comparison with the early infection group,and the differences were statistically significant(p<.05).There was no statistically significant difference in the other indicators between the two groups(p>.05).Conclusions:Intrauterine infection in different periods can inhibit placental and endometrial angiogenesis,and affect the survival rate of fetal rats and the growth and development of brain and lung.The reason may be related to the aggravation of fetal inflammatory responses and oxidative stress.The earlier the intrauterine infection occurs,the severer the adverse effects on the fetal rats will be.

Microbiology laboratory and the management of motherchild varicella-zoster virus infection

Varicella-zoster virus, which is responsible for varicella(chickenpox) and herpes zoster(shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella(particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times:(1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection;(2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear(atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation;(3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and(4) when the baby is born and it is necessary to confirm a diagnosis of varicella(and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.

Immunobiology of congenital cytomegalovirus infection of the central nervous system--the murine cytomegalovirus model

Congenital human cytomegalovirus infection is a leading infectious cause of long-term neurodevelopmental sequelae, including mental retardation and hearing defects. Strict species specificity of cytomegaloviruses has restricted the scope of studies of cytomegalovirus infection in animal models. To investigate the pathogenesis of congenital human cytomegalovirus infection, we developed a mouse cytomegalovirus model that recapitulates the major characteristics of central nervous system infection in human infants, including the route of neuroinvasion and neuropathological findings. Following intraperitoneal inoculation of newborn animals with mouse cytomegalovirus, the virus disseminates to the central nervous system during high-level viremia and replicates in the brain parenchyma, resulting in a focal but widespread, non-necrotizing encephalitis. Central nervous system infection is coupled with the recruitment of resident and peripheral immune cells as well as the expression of a large number of pro-inflammatory cytokines. Although infiltration of cellular constituents of the innate immune response characterizes the early immune response in the central nervous system, resolution of productive infection requires virus-specific CD8＋ T cells. Perinatal mouse cytomegalovirus infection results in profoundly altered postnatal development of the mouse central nervous system and long-term motor and sensory disabilities. Based on an enhanced understanding of the pathogenesis of this infection, prospects for novel intervention strategies aimed to improve the outcome of congenital human cytomegalovirus infection are proposed.

Prevention of intrauterine infection by hepatitis B virus with hepatitis B immune globulin:efficacy and mechanism

Objective To evaluate the efficacy of hepatitis B immune globulin (HBIG) in preventing intrauterine infection by hepatitis B virus (HBV) and to investigate its mechanism. Methods Forty eight pregnant women positive for hepatitis B surface antigen (HBsAg) were randomly divided into 2 groups. The 34 women in the study group were injected with HBIG during pregnancy; the other 14 women were controls. Maternal blood samples were taken before HBIG injection and at delivery. Neonatal blood samples were taken within 24 hours after birth before HBIG and hepatitis B vaccine were given. HBsAg and antibody to HBsAg (anti HBs) were tested by radioimmunoassay. Results None of the 35 newborns (including 2 twins) in the study group was positive for HBsAg, but 3 (21%) in the control group were positive (P=0.02). The HBsAg titers in the women in the study group decreased after HBIG injection. Of the 35 newborns in the study group, 32 (91%) were positive for anti HBs. Conclusion Systematic injections of HBIG during pregnancy may prevent intrauterine HBV infection, the mechanism of which may be reduction of maternal HBV viremia and production of fetal passive immunity.

Expression and its clinical significance of HLA-G in HCMV-infected placenta] villi at early pregnant stage

Objective：To study the expression and its clinical significance of HLA-G in HCMV intrauterine infected placental villi at early pregnant stage. Methods：PCR （polymerase chain reaction） was used to screen the peripheral blood for HCMV-DNA in 462 women who had willingly undergone induced abortion. Then immunohistochemistry was also used to detect expressions of mouse anti-HCMV early antigen （HCMV-EA） and mouse anti-HLA-G in HCMV-DNA positive cases＇ placental villi. The difference of HLA-G expressions between the intrauterine infection group（HCMV-EA positives）, the intrauterine infection-free group（HCMV-EA negatives） and the normal control group （50 cases of healthy early placental villi） was compared. Results： Of the 78 cases, which were detected HCMV-DNA positive, 11 （14.10%） were HCMV-EA positive. Compared with the other two groups, HLA-G expressions in the intrauterine infection group were both obviously decreased（both P〈0. 001）. HLA-G expression positions in all three groups were mainly located in the cytotrophoblast. Conclusion：Intrauterine HCMV infection at early pregnant stage is closely related to HLA-G expression at the maternal-fetal interface. The virogenetic products may affect the expression of HLA-G at the maternal-fetal interface and that of its immunological function, thus leading to different clinical outcomes.

Ectopic intrauterine device in the bladder causing cystolithiasis:A case report

BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD in the bladder is rare.It occurs insidiously,has a long course,is associated with a high risk for injury,and is difficult to treat.CASE SUMMARY A 44-year-old woman was admitted for repeated episodes of urinary frequency,urgency,and dysuria over three months.Laboratory tests revealed significantly elevated urine leukocytes and bacteria.Urine culture suggested colonization with Enterococcus faecalis.Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder.Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall.The foreign body measured approximately 1 cm.Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal.The majority of the IUD was located in the uterine cavity.Cystoscopy was performed,and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder.The IUD was then removed through hysteroscopy.CONCLUSION Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.

Congenital infection of rabbits with Schistosoma japonicum and protective immunity of offspring

Background Recently congenital infection with Schistosoma japonicum (S. japonicum) has been domonstrated in pigs, rabbits, mice and dogs. We explored the rabbit as an animal model for the congenital infection of schistosomiasis japonica and assessed the effect of a congenital S. japonicum infection on the resistance of rabbit kittens to a postnatal challenge infection.Methods Sixteen pregnant New Zealand white rabbits were infected with a single dose of S. japonicum cercariae. The exposed animals were divided into three groups according to the gestation age at the time of infection. Diagnosis of prenatally acquired S. japonicum infection in the rabbit kittens was primarily based on serological tests in combination with parasitological and histopathological findings. Congenitally infected kittens were challenged percutaneously with 100 S. japonicum cercariae to assess the effect of a congenital S. japonicum infection on kitten resistance to a postnatal challenge infection.Results The overall prevalence of congenital infection in offspring of infected mothers was 20% (12/60). The congenital infection rate in group L (late gestation) was much higher than in group E (early gestation) and group M (mid-gestation) (P<0.05). After a postnatal challenge infection, prenatally infected kittens had a 54.66% worm reduction rate, 41.45% egg reduction rate, and 51.76% granuloma size reduction rate compared to nave kittens.Conclusions This study demonstrates the possibility of congenital infection of S. japonicum in rabbits and the resistance of congenitally infected kittens to a postnatal challenge infection. These results have important implications not only for epidemiological investigations, but also in designing government control programs for schistosomiasis.

Lymphocytic choriomeningitis virus:An under-recognized congenital teratogen

BACKGROUND Lymphocytic choriomeningitis virus(LCMV)is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection.AIM To summarize the epidemiological,clinical,and diagnostic features of reported patients with congenital LCMV infection.METHODS A literature search was conducted in PubMed,Medline,Google Scholar,and ResearchGate.The keywords used were‘congenital lymphocytic choriomeningitis virus,’and 48 studies were included.In addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://www.referencecitationan alysis.com).RESULTS The results have shown 27 reports of congenital LCMV infection in 86 patients,with 52.73%of them being males.Patients presented with chorioretinitis(83.53%),hydrocephalus(54.12%),and psychomotor retardation or developmental delay(54.12%).Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly(74.07%),periventricular calcifications(66.67%),and microcephaly(40%).Most mothers of congenitally infected infants were exposed to rodents during pregnancy,predominantly mice,with flu-like symptoms mainly occurring during the first two trimesters of gestation.Mortality in congenitally infected children was 16.47%.The diagnosis of congenital LCMV infection was confirmed serologically in most patients(86.67%).CONCLUSION LCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae.Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH(T:Toxoplasma gondii,O:Other pathogens,R:Rubella virus,C:Cytomegalovirus,H:Herpes simplex virus)pathogens.

A Rare Case of Infective Mediastinitis after Melody Valve Implantation

Pulmonary valve implant is frequently necessary in children and adults with congenital heart disease.Infective endocarditis represents a rare but life-threatening complication after transcatheter pulmonary valve implantation.There are various treatments for native or prosthetic valve endocarditis.Surgical intervention,combined with intravenous antibiotic treatment,is of paramount importance,in case of concomitant mediastinal infection,in order to ensure the radical debridement of all infected tissue,avoiding any recurrent endocarditis.In this report,we describe a rare case of mediastinitis,associated with an infected endocarditis,occurring 8 months after Melody(Medtronic
,Minneapolis,USA)valve implant,successfully treated with the implantation of a homograft to reconstruct the right ventricular outflow tract.

Immediate and Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus—Comparison of Two Decades before and after Change in Antibiotic Infective Endocarditis Prophylaxis Guidelines

Objectives:To determine immediate and long-term follow-up of transcatheter closure of patent ductus arteriosus(PDA)in children.Background:National antibiotic prophylaxis(AP)guideline for infective endocarditis changed after 2009,the effect on practice of PDA closure is unknown.Methods:Observational single center study analyzing follow-up of PDA closure comparing two time periods before(2002–2009)and after(2010–2019)changes in AP guideline.Results:332 patients(68.1%female),median(interquartile range)age 3.0 years(1.5–5.7)and body weight 14.0 kg(10.0–19.3),were enrolled.PDA morphology was conical type A(50.3%),window type B(1.2%),tubular type C(40.1%),complex type D(2.1%),elongated type E(0.9%)and other(5.4%).Minimal PDA diameter and length were 1.9 mm(1.3–2.5)and 8.0 mm(6.2–10.2).PDA was closed using coils(56.3%),Amplatzer Duct Occluders(41.9%)and others(1.8%).Complete closure rate was 61.1%at catheter intervention,72.3%on day 1,87.7%after 6 months and 98.4%at last follow-up on echocardiography.Moderate complication rate(severity level 3)was 4.2%and major complication rate(severity level 4)0.3%,with no catastrophic complications(severity level 5).Annual PDA closure rate declined in the second time period(22.6/year vs.15.5/year,p=0.018),PDA size increased(1.6 mm vs.2.0 mm,p=0.002)and proportion of coils decreased(72.4%vs.37.1%,p<0.001).Conclusions:Interventional closure of PDA is associated with excellent closure rates during follow-up(>98%)and only a small number of complications leading to reintervention or surgery.Change in AP guidelines changed indication for and practice of PDA closure.

Neocuspidization of the Pulmonary Valve with Autologous Pericardium in the Adult Patient with Ventricular Septal Defect and Infective Endocarditis: A Case Report and Review of the Literature

Congenital heart disease (CHD) is one of the risk factors for developing infective endocarditis (IE). Right-sided IEoccurs in 5%–10% of endocarditis cases, and pulmonary valve (PV) is involved in less than 2% of such patients.Literature data are few, and optimal treatment methods, indications for surgery, and types of operative techniquesare still under debate. We present an adult patient with a rare combination of the ventricular septal defect (VSD)and PV IE who underwent surgical treatment. Neocuspidization with autologous pericardium was utilized for thereconstruction of his PV. We discuss details of this novel surgical technique.

Congenital sepsis caused by <i>Eikenella corrodens</i>

Eikenella corrodens is a part of normal human oral flora and a rare cause of intrauterine and neonatal infections. We describe a case of congenital E. corrodens sepsis with positive blood cultures at birth in the setting of low maternal risk factors for infection. Our case is one of two reported cases of congenital E. corrodens sepsis resulting in newborn survival.

Several Immunological Parameters in Rabbit Kittens Born to <i>S. japonicum</i>-Infected Mothers

In this study we explored the rabbit as an animal model for the congenital infection of schistosomiasis japonica and assessed the effect of a congenital S. japonicum infection on the resistance of rabbit kittens to a postnatal challenge infection. Kittens were challenged 17-19 weeks after the primary infection of their mothers. Perfusion was undertaken six weeks after the challenge. At this time parasitological, pathological and immunological parameters, worm reduction rate, granuloma size reduction rate, egg reduction rate, IgG and IgM responses were assessed and compared to that of kittens born to un-infected mothers. The overall prevalence of congenital infection in kittens of infected mothers was 20% (12/60). After a postnatal challenge infection, prenatally infected kittens had a 54.66% worm reduction rate, 41.45% egg reduction rate, and 51.76% granuloma size reduction rate compared to naive kittens. Congenital infection decreases the IgM responses by 39.47% while it increases the IgG responses by 56.22%. Together, these results indicate that congenital infection induce long-term effects on pathology and immune response patterns in rabbits’ subsequently challenge with S. japonicum cercariae.