Human brucellosis in a nonendemic country: a report from Germany, 2002 and 2003

Human brucellosis has become a rare disease in Germany since the eradication of bovine and ovine/caprine brucellosis in this country. Therefore, most physicians are unfamiliar with the illnesses clinical presentation, diagnostic tools, and therapeutic strategies. This retrospective study was carried out to evaluate the epidemiological, clinical, and laboratory features of human brucellosis in Germany in the years 2002 and 2003. Thirty-one bacterial isolates from 30 patients sent to the German national reference laboratory were characterized using the genus-specific bcsp31 real-time PCR, the species-specific AMOS-PCR, and standard microbiological methods for the detection and identification of Brucella spp. The medical records of all patients with bacteriologically confirmed brucellosis were evaluated. All 31 isolates proved to be Brucella (30 Brucella melitensis and 1 Brucella suis). Most of the brucellosis patients were infected in endemic countries while visiting friends and relatives during their summer holidays. One case of laboratory-acquired infection was identified. Brucellosis was transmitted mainly by the consumption of contaminated unpasteurized milk or cheese from goats and sheep. The patients presented primarily with flu-like symptoms, i.e. fever, chills, sweating, headaches, arthralgia, and myalgia. In most cases, however, symptoms and signs of focal complications, e.g. spondylitis, endocarditis, and meningoencephalitis, predominated. The rate of complications was much higher than that in endemic countries, presumably as a result of diagnostic delay due to a low index of suspicion. In summary, physicians in nonendemic countries such as Germany must be aware of brucellosis being a possible cause of fever of unknown origin in immigrants and tourists travelling from endemic countries.     

Über Versuche,die Therapeutische Wirkung Antitoxischer Heilsera zu Verbessern

Ohne Zusammenfassung     

Ultrastructure of the spermatozoon of the pseudophyllidean cestode Eubothrium crassum (Bloch, 1779)

The fine structure of the mature spermatozoon of the pseudophyllidean tapeworm Eubothrium crassum, a parasite of salmonid fishes, has been studied by transmission electron microscopy for the first time. The mature spermatozoon of E. crassum is filiform and tapered at both extremities. It contains two axonemes of unequal length showing the 9 + "1" pattern of Trepaxonemata. The anterior extremity exhibits a crested body 50-100 nm thick. It spirals around the outside of the anterior region of the spermatozoon. The nucleus is electron-dense, exhibiting a fibrous appearance in its middle (the broadest) region. The cortical microtubules are of two types and are situated parallel to the spermatozoon axis. The cytoplasm is slightly electron-dense and contains numerous electron-dense granules in region II of the spermatozoon. A ring of electron-dense, centred microtubules surrounds the axoneme, together with the underlying ring of moderately electron-dense, subjacent submicrotubular material in region V. The anterior and posterior extremities of the spermatozoon lack cortical microtubules and contain a single axoneme. Our results reveal several peculiarities, in which the spermatozoon of E. crassum differs from those of other pseudophyllidean cestodes.     

Impaired Ca-signaling in astrocytes from the Ts16 mouse model of Down syndrome

The trisomy 16 mouse model of Down syndrome has been used to compare calcium (Ca)-homeostasis and Ca-signaling in astrocytes from trisomic mice and from diploid littermates. Ratio calcium-imaging of Fura-2/AM loaded primary astroglial cultures prepared from the hippocampus shows that resting Ca levels are on average significantly higher in trisomic than in the control astrocytes (280 vs. 120 nM). Serotonin (3 μM) and glutamate (30–300 μM) evoked transient Ca-increases from 400 to 600 nM in euploid but from only 20 to 150 nM in trisomic astrocytes. Imaging of ATP-driven Ca-accumulation in cellular organelles revealed a significantly stronger uptake of Ca in trisomic astrocytes that might buffer cytosolic Ca-increases. Our results demonstrate major disturbances in Ca-signaling in trisomic astrocytes that are likely to be of pathophysiological relevance.     

Multicenter, randomized, double-blind comparison of erythromycin estolate versus amoxicillin for the treatment of acute otitis media in children

Erythromycin is frequently prescribed in Germany for acute otitis media, but well-designed clinical trials under present epidemiological conditions are lacking. Therefore, a double-blind, randomized, multicenter trial was performed to compare the clinical efficacy and safety of erythromycin estolate versus amoxicillin in children with acute otitis media and to identify the risk factors associated with clinical failure. Investigators from 19 centers throughout Germany recruited 302 children with clinical, otoscopic, and tympanometric evidence of acute otitis media. In a double-blind fashion, patients were allocated randomly to a 10-day course of erythromycin estolate at 40 mg/kg/day in two divided doses or amoxicillin at 50 mg/kg/day in two divided doses. Clinical examinations, otoscopy, and tympanometry were performed at baseline, day 3–5, day 9–11, and at 5 weeks. Clinical outcome was assessed on day 9–11. Two-hundred eighty children were evaluable for efficacy (erythromycin group, 141; amoxicillin group, 139). Both groups were comparable with respect to demographic data and severity of disease at entry. Treatment was successful in 94% of the erythromycin-treated patients and in 96% of the amoxicillin-treated patients. Clinical outcome was statistically equivalent between groups within a range of 7 percentage points. Clinical recurrence was seen in eight erythromycin-treated children (5.7%) and in seven amoxicillin-treated children (5.0%) (P=0.81). Patients with bilateral disease at entry were at higher risk of unfavourable outcome, whereas age and presence/absence of otorrhea at entry were not associated with outcome. Treatment-related adverse events were recorded in eight (5.3%) of 151 erythromycin-treated patients and in 11 (7.3%) of 151 amoxicillin-treated patients. In this study in an outpatient setting in Germany, erythromycin estolate was as safe and effective as amoxicillin in the treatment of acute otitis media. Both drugs can be administered in a convenient twice-daily dosage schedule.     

Synthesis and characterization of monomethacrylate-functionalized self-organizing crown ether compounds

Synthesis and characterization of methacrylate-monofunctionalized crown ether compounds based on derivatives of 2-hydroxymethyl-1,4,7,10,13-pentaoxacyclopentadecane and 4′-hydroxymethyl-1,4,7,10,13-pentaoxabenzocyclopentadecane is described. By differential scanning calorimetry (DSC) and thermooptical analysis (TOA) it is shown that the synthesized compounds and their sodium triflate complexes exhibit columnar mesophases.     

Immunoblot analysis of the serological response in Hantavirus infections

Sera from patients with nephropathia epidemica (NE) or Korean hemorrhagic fever (KHF) were tested for specific antibody response to antigens of H?lln?s virus and Hantaan virus strain 76-118. A Vero E6 derived cell line persistently infected with H?lln?s virus strain B1, and Vero E6 cells freshly infected with Hantaan virus type strain 76-118 were used as antigens in the immunofluorescence assay (IFA) and the immunoblot. Blots were prepared from whole cell lysates. The convalescent-phase sera of NE patients tested in this study regularly revealed a marked reaction with a 52 kilodalton (Kd) protein of H?lln?s virus and a 50 Kd protein of Hantaan virus. A convalescent serum from a patient with Korean hemorrhagic fever and a rat antiserum against Hantaan virus could recognize the 50 Kd band of Hantaan virus but showed no apparent reactivity with the 52 Kd component of H?lln?s virus in the standard dilutions. Some sera could additionally identify minor bands in the 55 Kd and/or 67 Kd region of the blots. A one-way cross reactivity between Hantaan and H?lln?s viruses was also evident from the results of the immunofluorescence assays in that NE convalescent sera reacted with both viruses, whereas KHF convalescent or anti-Hantaan sera gave strongly positive results with Hantaan virus but only faint reaction with H?lln?s virus.     

Epidemiology of molluscum contagiosum using genetic analysis of the viral DNA

The molecular epidemiology of molluscum contagiosum virus (MCV) infections was investigated by restriction endonuclease analysis of the genomes of 222 separate isolates collected from 147 patients living in Germany (33 patients), Hong Kong (6 patients), and Scotland (108 patients). MCV type 1 (MCV-1) caused 96.6% of the infections, and MCV type 2 (MCV-2) caused 3.4%. However, isolates from four of the 142 MCV-1-infected patients and two of the five MCV-2-infected patients showed minor differences in their DNA restriction patterns because of the loss of a single or very few recognition sites for the enzymes used. No genome variations were detected amongst isolates collected from different sites or on several occasions from individual patients or from closely related patients. Southern blot hybridization revealed a high level of relatedness between MCV-1 and 2. No differences were seen in the appearance or anatomical localization of lesions caused by either virus type. In particular, there was no preferred genital localization for MCV-2 infections.     

The influence of inhomogeneous volume conductor models on the ECG and the MCG

The authors investigated the influence of human body inhomogeneities such as the lungs, blood masses and the skeletal muscle layer on the electrical body surface potential and the magnetic field. The surface potentials and magnetic fields are calculated using a boundary element method. As a rule the blood masses have a large influence on both potential and magnetic field amplitude as well as on the potential and magnetic field map orientation, but the influence on the topology of the map is less in the electric case than in the magnetic case. The single-dipole reconstruction was applied to estimate the error caused by neglecting inner inhomogeneities in source localization. The neglect of lungs and blood masses results in a localization error of less than 1 cm in the electric case but more than 1 cm for deep sources at the posterior side of the heart in the magnetic case. The authors tried to assess the influence of the skeletal muscle layer by both an analytical two-layered anisotropic half-space model and the torso extension method. The skeletal muscle layer causes a smoothing effect on the electrical surface potential and to a lesser extent on the magnetic field, leading to an overestimation of the actual source depth of about 1-2 cm. In principle this can be reduced by taking data from all over the thoracic surface. The authors designed experiments for simultaneous measurement of body surface potential and extracorporeal magnetic field from the same subject. The evaluation of data from two patients showing Wolff-Parkinson-White syndrome has shown that localization results from electric potential data and magnetocardiographic data are consistent.