Borrelia burgdorferi and the causative agent of human granulocytic ehrlichiosis in deer ticks, Delaware

During the 1998 hunting season in Delaware, 1,480 ticks were collected from 252 white- tailed deer; 98% were Ixodes scapularis, a significant increase from the 85% reported in 1988. Ticks were tested for Borrelia burgdorferi and the causative agent of human granulocytic ehrlichiosis. Infection rates remained stable in New Castle and Kent counties, but increased from <1% to 8% in sussex county.     

PPD-induced monocyte chemotactic factor production by human milk cells

The functional capability of antigen-stimulated breast milk cells to produce an immunologic mediator was examined. Colostrum and comparison peripheral blood samples were obtained from ten women, two to four days postpartum, and supernatants from PPD-stimulated mononuclear cell cultures were assayed for the lymphokine, monocyte chemotactic factor. Five of the ten women studied had a history of a positive tuberculin skin test and one had received BCG immunization. Peripheral blood lymphocyte cultures and colostrum cell cultures from four of these six women produced monocyte chemotactic factor. These results demonstrated the functional capability of antigen-stimulated colostral cells to produce immunologic mediators.     

Spinal cord stimulation electrode design: prospective,randomized, controlled trial comparing percutaneous and laminectomy electrodes-part I: technical outcomes

OBJECTIVE: The clinical use of spinal cord stimulation for treatment of chronic intractable pain has been increasingly successful because of recent technical improvements, particularly the development of multiple-contact electrodes supported by programmable implanted pulse generators. Contemporary electrodes can be placed percutaneously in some cases and require a limited laminectomy in other cases. METHODS: We performed a prospective, randomized, controlled trial comparing two prototypical electrode designs, using a computerized system that allows direct patient interaction and quantitative measurements. A series of 24 patients with chronic lumbosacral pain syndromes first underwent testing with percutaneous four-contact electrodes and then underwent implantation, at the same spinal level, of one of two different electrode configurations; 12 patients received a new percutaneous four-contact electrode of the same design and 12 received an insulated four-contact array, which was implanted via laminectomy. RESULTS: The insulated array performed significantly (P = 0.0005-0.0047) better than the temporary percutaneous electrode for the same patients, according to all three measures tested (ratings of paresthesia coverage of pain, coverage calculated from patient drawings, and amplitudes), at the "usage" amplitude for the three standard bipoles examined. The insulated array also performed significantly (P = 0.0000-0.026) better than the permanent percutaneous electrode in terms of coverage ratings and amplitude requirements. Low back coverage ratings were significantly better for the insulated array than for the temporary percutaneous electrode, and scaled amplitudes necessary for low back coverage were significantly better for the permanent percutaneous electrode than for the temporary electrode. In comparison with the percutaneous temporary electrode, at subjectively identical stimulation intensities, the permanent insulated array required significantly lower amplitude. CONCLUSION: We can immediately infer from these technical data that the use of an insulated array, in comparison with a percutaneous electrode, would double battery life. Extended follow-up monitoring will be required to assess the extent to which the technical advantages we observed for the insulated array might be associated with improved clinical outcomes.