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BACKGROUND: Thrombosis of the soleal and gastrocnemial veins seldom receive very much attention. It is thought that they are frequently the starting point for deep vein thrombosis of the lower extremity. PATIENTS AND METHODS: 125 patients with clinically suspected deep vein thrombosis of the leg were examined by means of duplex sonography and phlebography. The ultrasound examination was performed on the lower limb in the form of a compression sonography. RESULTS: From 137 legs examined, a total of 82 cases of deep vein thrombosis were diagnosed. Sonographically and/or phlebographically, the soleal and/or gastrocnemial veins were found to be involved in 65 cases of thrombosis, i.e. 79% of all thrombosis. 25% of all cases of deep vein thrombosis of the leg were isolated muscular vein thrombosis. Pain in the calf while walking, similar to muscular soreness after exertion, was typical of the isolated muscular vein thrombosis. The muscular veins were involved in all the deep vein thrombosis of the leg of the 3- and 4-layer type. Diagnosis of soleal and gastrocnemial vein thrombosis is quite possible by means of sonography and phlebography. The sensitivity and specificity of the compression sonography were 88% and 95% respectively, compared to the phlebography. CONCLUSION: In patients suffering from pain in the calf, the soleal and gastrocnemial veins should be carefully included in the sonographic or phlebographic assessment. Due to the risk of deep vein thrombosis, isolated muscular vein thrombosis should receive treatment appropriate for a deep vein thrombosis of the calf, and its development be checked.

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Antisense oligodeoxynucleotide strategies have been employed in a variety of eukaryotic systems both to understand normal gene function and to block gene expression. Pharmacologically, 'code blockers' are ideal agents for antitumour and antimicrobial treatments because of their specific mode of action. Here we report the inhibition of duck hepatitis B virus (DHBV) by antisense oligodeoxynucleotides in primary duck hepatocyte cultures in vitro as well as in DHBV-infected Pekin ducks in vivo. The most effective antisense oligodeoxynucleotide was directed against the 5' region of the pre-S gene and resulted in a complete inhibition of viral replication and gene expression in vitro and in vivo. These results demonstrate the application of antisense oligodeoxynucleotides in vivo and exemplify their potential as human antiviral therapeutics.

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One hundred and seventeen ducklings, 42 inoculated with duck hepatitis B virus (DHBV) 2 days after hatching and 55 connatally infected, were studied over a 6-month period in parallel with 20 ducklings without DHBV infection. Using immunohistochemical, in situ and blot hybridization analyses, the natural course of hepatic and extrahepatic infection was examined. DHBV infection started in the liver 2-4 days post-inoculation. There, DHBV was found not only in hepatocytes, but also in bile duct epithelial cells. Further, DHBV infection occurred in exocrine and endocrine pancreas (beginning 6-10 days and 20 days post-inoculation, respectively) and in germinal centers of the spleen (beginning 8 weeks post-inoculation). Occasionally viral DNA was also found in kidney glomeruli. Using strand-specific RNA probes, viral DNA in pancreas and spleen was clearly demonstrated to be replicating intermediates. Hepatic and extrahepatic infection with DHBV was not associated with histologic inflammation or pathologic changes in these tissues or the liver. These data indicate that DHBV can infect cells other than hepatocytes. The biological significance of non-hepatocyte infection for the life-cycle of the virus and its potential significance for viral persistence remain to be determined.

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In the course of studies on the biology of hepadnavirus infections, duck hepatitis B virus (DHBV) DNA was isolated from the serum of a German Pekin duck. Viral DNA was cloned in E. coli using pBR 322 DNA as a vector. The cloned DHBV DNA F 1-6 was characterised by restriction enzyme analyses. DHBV DNA F 1-6 was subcloned in both orientations in plasmid pSP 65 to produce strand-specific RNA probes. These probes specifically identified asymmetrically replicating nascent minus-strand DHBV DNA species or plus-strand viral RNA transcripts.

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Interruption of the inferior vena cava by an umbrella-filter, clip or Green-field-filter has been performed in more than 400 patients during the past 14 years. Overall hospital mortality was 1% by clip application and 7% by Mobin-Uddin-umbrella. The indication for this method is limited to those patients suffering from recurrent pulmonary embolism, despite correct anticoagulation, and if thrombectomy is insufficient or contraindicated. Inferior vena cava patency was objectively assessed in 121 patients by cavogramm. Caval patency of 95% in those with Greenfield-filter and clip was significancy greater than the 15% patients seen with Mobin-Uddin devices. Venous status was objectively assessed in 45 patients by intracaval measuring the pressure in front of and behind the stenosis.

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In 9 out of 24 cases we experienced complications when implanting the Kimray-Greenfield-Filter. As a result of this the introduction of this filter is now performed by a guide wire. To obtain maximum results the introducer and the filter itself should be improved.

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