Drinking Water Quality and the Geospatial Distribution of Notified Gastro-Intestinal Infections

Introduction

Even brief episodes of fecal contamination of drinking water can lead directly to illness in the consumers. In water-borne outbreaks, the connection between poor microbial water quality and disease can be quickly identified. The impact of non-compliant drinking water samples due to E. coli taken for regular monitoring on the incidence of notified acute gastrointestinal infections has not yet been studied.

Methods

The objective of this study was to analyse the geographical distribution of notified acute gastrointestinal infections (AGI) in Slovenia in 2010, with hotspot identification. The second aim of the study was to correlate the fecal contamination of water supply system on the settlement level with the distribution of notified AGI cases. Spatial analysis using geo-information technology and other methods were used.

Results

Hot spots with the highest proportion of notified AGI cases were mainly identified in areas with small supply zones. The risk for getting AGI was drinking water contaminated with E. coli from supply zones with 50–1000 users: RR was 1.25 and significantly greater than one (p-value less than 0.001).

Conclusion

This study showed the correlation between the frequency of notified AGI cases and non-compliant results in drinking water monitoring.     

头颈部横纹肌肉瘤11例临床病理学分析

目的：探讨头颈部横纹肌肉瘤（rhabdomyosarcoma,RMS）的临床病理学特征、免疫表型及鉴别诊断。方法：回顾性分析11例头颈部 RMS 的临床资料、病理形态和免疫组织化学标记结果。结果：11例患者中男性8例,女性3例。年龄2～51岁,中位年龄25岁。主要表现为头颈部痛性或无痛性肿块,组织学分型：胚胎型8例,腺泡型3例。免疫组织化学结果显示瘤细胞均表达结蛋白、波形蛋白;肌调节蛋白（MyoD1）、生肌蛋白（myogenin）的阳性率分别为45％、55％;2例表达突触素,所有病例均不表达广谱角蛋白、白细胞共同抗原及 S-100。术后随访6个月～5年,其中2例死亡,4例复发,2例转移。结论：头颈部横纹肌肉瘤罕见,临床症状不典型,病理诊断需结合组织学形态及免疫表型。     

SULPHASALAZINE INDUCED AUTOIMMUNE SYNDROME

A case of an unusual and severe reaction to sulphasalazine isreported. KEY WORDS: Second line agent, Systemic steroids, Sulphasalazine     

E-selectin-dependent neutrophil adhesion to Rickettsia rickettsii- infected endothelial cells

Increased neutrophil or HL60 cell adhesion to Rickettsia rickettsii- infected endothelial cells (ECs) was observed at 6 to 8 hours after the initiation of infection, diminishing by 24 hours. Similar increases were observed using formaldehyde-fixed neutrophils. Cellular association and likely the intracellular presence of rickettsiae was required for enhanced neutrophil adhesion, because culture medium conditioned by infected cells or rickettsiae rendered noninfective by pretreatment with tetracycline were ineffective at inducing neutrophil adhesion. Increases in neutrophil adhesion caused by infection were blocked by pretreatment of ECs with cycloheximide, suggesting the involvement of new protein synthesis in the cells' response. Flow cytometric analysis of infected cells showed increases in cell surface expression of E-selectin compared with uninfected control cells. Furthermore, incubation of 6- to 8-hour infected cells with a blocking monoclonal antibody against E-selectin (BB11) inhibited neutrophil adhesion an average of 61%. These results suggest the involvement of E- selectin in neutrophil adhesion to infected ECs occurring early in the course of the infection process. EC-initiated recruitment of neutrophil adhesion during rickettsiae infection could contribute to the pathologic changes associated with Rocky Mountain Spotted Fever.     

IMMUNOGENETICS OF GRAVES'' OPHTHALMOPATHY

We have performed an immunogenetic analysis of 53 patients with severe Graves' ophthalmopathy, 51 patients with Graves' disease but little or no clinically apparent eye disease, and 90 controls. The distribution of restriction fragment length polymorphisms was analysed in the three groups, using probes for the HLA-DQ alpha and DR beta regions, the T-cell receptor C alpha, V alpha, C beta and J gamma genes and the immunoglobulin gene switch regions, S alpha and S mu. There was no abnormal distribution of these polymorphisms in either group of Graves' patients, or differences between the Graves' patients with or without eye disease. It was possible to assign HLA-DR types in most patients using the polymorphisms found after probing with DQ alpha and DR beta; there was no abnormal distribution of DR types (including HLA-DR3) assigned by restriction fragment polymorphisms in the two Graves' groups. These results fail to confirm the reported associations between ophthalmopathy and HLA-DR3 and between Graves' disease and the T-cell receptor C beta polymorphism; they also argue against a strong influence of Gm allotypes in Graves' disease since these genes are in linkage disequilibrium with the S alpha polymorphisms. The association of Graves' disease with HLA-DR3, defined hitherto using serological reagents, may be less strong than previously described.     

Myxoma of the kidney

A 62-year-old man had a right renal mass incidentally diagnosed by ultrasonography. Magnetic resonance imaging revealed a well-defined right renal mass with homogenous low-signal intensity on the T(1)-weighted pulse sequence and heterogeneous high-signal intensity on the T(2)-weighted pulse sequence. A right nephrectomy was performed. The histological examination showed a myxoma, which is a very uncommon neoplasm in the kidney. Eight cases have been reported previously.