An undesirable byproduct from recombinant adenoviral vectors is the emergence of replication competent adenovirus (RCA) that result from rare homologous recombination events between the viral E1-containing (permissive) mammalian host cell genome and the virus itself, restoring the E1 gene to the viral genome. To reduce or eliminate the problem of RCA, we evaluated production of a first generation Ad5 vector (Ad5FGF4) in the cell line PER.C6. This E1-transformed human cell line contains only Ad5 nucleotides 459-3510, which precludes double crossover-type homologous recombination because the Ad5FGF-4 only contains 5' Ad5 sequence up to nucleotide 453. The Ad5FGF4 vector does, however, retain 177 nucleotides of the 3' end of the E1B-55K gene that are also present in PER.C6. With only this single region of homology between vector and cell line, we were surprised to detect virus-specific cytopathic effects (CPE) in our cell-based assay for RCA. This CPE-inducing agent was amplified in nonpermissive A549 cells but also supported amplification of the parental Ad5FGF-4. Because we were unable to isolate the CPE-inducing agent in pure form we first identified it as atypical RCA. Polymerase chain reaction (PCR) and Southern blot experiments identified viral DNA segments in which recombination had occurred between the 177 nucleotides of E1B present in both Ad5FGF-4 and PER.C6. The atypical RCA genomes contain a copy of the original (PGK promoter-E1 gene carrying) plasmid used in the construction of the PER.C6 cell line and they retained the parental FGF-4 transgene. However, significant deletions occurred within the recombined genomes in compensation for the large insertion from PER.C6 sequences and resulted in the loss of essential viral genes. This deletion renders these recombinant viruses replication defective, requiring helper functions from remaining parental Ad5FGF-4 for amplification. These atypical RCA entities may be more properly designated as helper-dependent E1-positive particles (HDEPs). This finding shows the importance of avoiding the use of "nonmatched" vectors where any overlap exists between the recombinant vector and E1 sequences in the packaging cell line. The cloning of the FGF-4 transgene into an adenoviral vector specifically "matched" for PER.C6 (lacking the 177 nucleotide region of homology) has allowed extensive virus propagation (Ad5.1FGF-4) with no CPE- or HDEP-like events yet detected.
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Eur Heart J Case Rep
November 2024
Department of Cardiology and Electrotherapy, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, ul. Marii Curie Skłodowskiej 9, 41-800 Zabrze, Poland.
Background: We report the case of a 63-year-old white Caucasian male patient admitted to the clinic because of atypical angina and palpitations. Other comorbidities included hypertension, hyperuricaemia, and hypercholesterolaemia. He was admitted to a tertiary cardiac centre for deepened diagnostics of his complaints.
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January 2025
General Hospital of Florina "Eleni Th. Dimitriou", Department of Cardiology, Egnatias 9, Florina 53100, Greece.
A single coronary artery (SCA) is a rare congenital anomaly with an incidence of 0.024 - 0.066% in angiographies and potential implications for adverse events depending on the course of the anomalous artery.
View Article and Find Full Text PDFJ Electrocardiol
December 2024
Institute of Cardiology, Madras Medical College, Chennai 600 003, India. Electronic address:
We report a case of a 53-year-old male with inferolateral myocardial infarction, presenting an atypical Aslanger pattern on electrocardiogram (ECG). The ECG showed ST elevation in leads III, aVR, aVF, and posterior leads, with ST depression in II and V2-V6 with terminal positive T waves. Coronary angiography revealed total occlusion of the left circumflex artery (LCx) with significant stenosis of the left anterior descending (LAD) and right coronary artery (RCA).
View Article and Find Full Text PDFIntern Emerg Med
October 2024
Department of Geriatrics and Emergency Care, IRCCS, Italian National Research Centres on Aging (I.N.R.C.A.), Via della Montagnola n. 81, 60127, Ancona, Italy.
Constipation and fecal impaction are common issues with the potential for significant morbidity in older people presenting to the Emergency Department (ED). While many of these patients present with classical symptoms of constipation or fecal impaction, atypical presentations are also frequent. These atypical presentations may include paradoxical diarrhea, fecal incontinence, urinary retention or overflow incontinence, hyperactive or hypoactive delirium, anorexia/dysphagia, and syncope.
View Article and Find Full Text PDFCureus
May 2024
Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.
Acute coronary syndrome (ACS) presents significant diagnostic challenges, particularly in cases with atypical presentations and complex clinical scenarios. Here, we describe the case of a 59-year-old man who presented with presyncope, bradycardia, hypotension, and later syncope, attributed to the Bezold-Jarisch reflex. Electrocardiographic findings suggested both inferior and anterior wall infarction, with dynamic changes in T-wave morphology further complicating the diagnostic process.
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