Borrelia garinii in seabird ticks (Ixodes uriae), Atlantic Coast, North America

Borrelia garinii is the most neurotropic of the genospecies of B. burgdorferi sensu lato that cause Lyme disease in Europe, where it is transmitted to avian and mammalian reservoir hosts and to humans by Ixodes ricinus. B. garinii is also maintained in an enzootic cycle in seabirds by I. uriae, a tick found at high latitudes in both the Northern and Southern Hemispheres. To determine whether B. garinii is present in seabird ticks on the Atlantic Coast of North America, we examined 261 I. uriae ticks by polyclonal antiborrelial fluorescent antibody. Ten of 61 ticks from Gull Island, Newfoundland, were positive for borreliae by this screen. Amplicons of DNA obtained by PCR that targeted the B. garinii rrs-rrla intergenic spacer were sequenced and matched to GenBank sequences for B. garinii. The potential for introduction of this agent into the North American Lyme disease enzootic is unknown.     

Respiratory health in Turkish asbestos cement workers: the role of environmental exposure

AIM: Benign and malignant pleural and lung diseases due to environmental asbestos exposure constitute an important health problem in Turkey. The country has widespread natural deposits of asbestos in rural parts of central and eastern regions. Few data exists about the respiratory health effects of occupational asbestos exposure in Turkey. A cross-sectional study was conducted to investigate respiratory health effects of occupational asbestos exposure and the contribution of environmental asbestos exposure. METHODS: Investigations included asbestos dust measurements in the workplace and application of an interviewer-administered questionnaire, a standard posteroanterior chest X-ray and spirometry. Information on birthplace of the workers was obtained in 406 workers and used to identify environmental exposure to asbestos, through a map of geographic locations with known asbestos exposure. RESULTS: Asbestos dust concentration in the ambient air of the work sites (fiber/ml) ranged between 0.2 and 0.76 (mean: 0.25, median: 0.22). Environmental exposure to asbestos was determined in 24.4% of the workers. After the adjustment for age, smoking, occupational asbestos exposure, and potential risk factors environmental asbestos exposure was associated with small irregular opacities grade > or = 1/0 (44.2% vs. 26.6%, P < 0.01), FVC% (97.8 vs. 104.5, P < 0.0001), and FEV1% (92.4 vs. 99.9, P < .0001). Occupational exposure to asbestos was associated with small irregular opacities grade > or = 1/0 (OR: 2.0, 95% CI: 1.3-3.1, per 1 unit increase in the natural logarithm of fiber/ml) and FEV1/FVC% (beta: 1.1, SEM: 0.54; P < 0.05, per 1 unit increase in the natural logarithm of fiber/ml). CONCLUSIONS: Environmental exposure to asbestos could increase the risk of asbestosis and lung function impairment in workers occupationally exposed to asbestos, independent from occupational exposure and smoking.     

Alcohol and Indian porphyrics

The role of alcohol as the precipitating factor in the induction of acute attacks of acute intermittent porphyria was studied in an Indian population. Thirty-four teetotal patients with acute intermittent porphyria, in remission, were given 60 ml of 30% ethanol. Except for two patients, all had negative Watson-Schwartz tests prior to the alcohol. Within 24 hours, the Watson-Schwartz test became positive in 16 of these 32 patients (50%). In 8 out of the 34 patients (23.5%) a clinical attack was precipitated, including both patients who had a positive Watson-Schwartz test prior to the alcohol. It was concluded that alcohol does precipitate an acute attack in a significant percentage of patients of Indian origin with acute intermittent porphyria. Patients already excreting porphobilinogen are at a greater risk of developing an acute attack on alcohol ingestion. This study is the first from India and probably first of its kind to be reported from any country.     

Kinetic aspects of cycloheximide-induced reversal of adrenocorticotropin effects on steroidogenesis and adrenal phospholipids in vivo.

Intraperitoneal injection of maximally effective doses of corticotropin(1-24) [ACTH(1-24)] provoked maximal increases in rat adrenal phospholipids as follows: phosphatidic acid within 1.5-2 min, phosphatidylinositol and phosphatidylglycerol within 4-6 min, and polyphosphoinositides and corticosterone within 5-15 min. Continued maximal adrenal stimulation by ACTH(1-18) treatment caused sustained increases in adrenal phosphatidic acid, phosphatidylinositol, phosphatidylglycerol, polyphosphoinositides, and corticosterone. Treatment with cycloheximide during this steady-state caused rapid decreases in all of these substances to basal levels. The observed half-lives of adrenal phosphatide acid, phosphatidylinositol, polyphosphoinositides, phosphatidylglycerol, and corticosterone during cycloheximide inhibition were 0.15, 1.0, 1.7, 3.3, and 3.5 min, respectively. Calculated production rates during maximal ACTH stimulation were 1060, 991, 90, 34, and 41 nmol/g of tissue per min, respectively. These findings suggest that (i) an initial effect of ACTH on de novo synthesis of phosphatidic acid can account for all subsequently observed increases in other phospholipid derivatives of CDP-diacylglycerol, (ii) a labile protein is required for the ACTH-induced increase in phosphatidic acid, (iii) the phosphatidate leads to polyphosphoinositide-polyglycerophospholipid pathway is rapidly and dramatically responsive to hormonal stimulation, (iv) changes in steroidogenesis correlate well with changes in this phospholipid pathway, and (v) stimulation of this pathway is rapidly reversible.     

Will New Metal Heads Restore Mechanical Integrity of Corroded Trunnions?

Background

Metal wear and corrosion from modular junctions in total hip arthroplasty can lead to further unwanted surgery. Trunnion tribocorrosion is recognized as an important contributor to failure. This study was performed to determine if new metal heads restore mechanical integrity of the original modular junction after impaction on corroded trunnions, and assess which variables affect stability of the new interface created at revision total hip arthroplasty.

Can magnetic resonance imaging predict the success of parturition in oxytocin-induced pregnant women?

The aim of this study was to assess whether magnetic resonance imaging could predict the outcome of attempted vaginal delivery in a group of pregnant women whose parturition had to be induced by oxytocin. The signal intensity and morphology alterations in the cervix of 21 full-term pregnant women were analyzed before the induction of parturition. T2-weighted gradient echo sequences were utilized and signal intensity in the cervix was measured from the anterior and posterior lips of the cervix. An index indicating the brightness range of the cervix was formulated to overcome the effects of the individual intensity changes. Imaging features including the signal intensity and the evidence of effacement were correlated with the actual type of delivery performed. Images were also assessed visually by two independent radiologists. Statistical analysis of brightness indexes that were considered to have a predictive value as an indicator for possible delivery was not significant. However, visually assessed signal intensity of the cervix correlated strongly with the type of delivery. Effacement itself was the most reliable parameter in predicting the progress of the delivery. In conclusion, MR imaging seems to be useful for predicting normal parturition in full-term pregnant women who need oxytocin induction. However, the presence of effacement seems to be a more reliable and practical parameter that will be preferred in that prediction. Received: 21 October 1998; Revised: 19 April 1999; Accepted: 21 October 1999     

Sonographic assessment of changes in thickness of different abdominal fat layers in response to diet in obese women

PURPOSE: We evaluated the potential application of sonography to monitor alterations in abdominal fat thickness in obese women before and after dieting. METHODS: This study included 40 obese women (mean age, 42.2 +/- 9.4 years; mean body mass index [BMI], 36.0 +/- 5.9 kg/m2) who underwent a 3-month low-calorie diet. Height, weight, waist circumference (WC), and hip circumference (HC) were measured. BMI and waist-to-hip ratio (WHR) were calculated. Abdominal subcutaneous (S) and intra-abdominal preperitoneal (P) fat were measured at their maximum (max) and minimum (min) thickness sites using a 7.5-MHz linear-array probe. Intra-abdominal visceral (V) fat was measured using a 3.5-MHz convex-array probe. Measurements were taken before and after caloric restriction. RESULTS: The mean weight was reduced from 88.6 +/- 17.1 kg to 83.0 +/- 15.9 kg (p < 0.0001). The mean changes in S(min) (r = 0.376, p = 0.017), S(max) (r = 0.508, (p = 0.001), P(min) (r = 0.439, p = 0.005), and V (r = 0.365, p = 0.022) fat thicknesses were positively correlated with change in weight; the change in P(max) fat thickness showed the best and most significant correlation (r = 0.591, p < 0.0001). BMI (r = 0.969, p < 0.0001), WC (r = 0.510, p = 0.001), and HC (r = 0.422, p = 0.007) changes were also positively correlated with weight change, but the WHR change (r = 0.019, p > 0.05) was not. CONCLUSIONS: All the abdominal fat layers, particularly the intra-abdominal P fat, will decrease in response to loss of body fat by dieting. Sonography seems to be useful in monitoring small variations in the thicknesses of abdominal S and intra-abdominal P and V fat.     

Exposure to anti‐PD‐1 causes functional differences in tumor‐infiltrating lymphocytes in rare solid tumors

The pervasive use of therapeutic antibodies targeting programmed cell death protein 1 (PD‐1) to boost anti‐tumor immunity has positioned this approach to become the standard‐of‐care for some solid tumor malignancies. However, little is known as to how blockade of PD‐1 may alter the function or phenotype of tumor‐infiltrating lymphocytes (TIL). We used our ongoing Phase II clinical trial of pembrolizumab for patients with rare solid tumors from various types (NCT02721732) with matched core biopsies taken at baseline and after initial dose of anti‐PD‐1 (15–21 days post‐dose) to elucidate this question. One fresh core needle biopsy was used to propagate TIL ex vivo to analyze phenotype and function using flow cytometry in both CD8⁺ and CD4⁺ TIL populations. An enriched CTLA‐4 expression in the CD4⁺ TIL population was observed in TIL expanded from the on‐treatment samples compared to TIL expanded from the matched baseline (n = 22, p = 0.0007) but was not observed in patients who experienced tumor regression. Impact on functionality was evaluated by measuring secretion of 65 soluble factors by expanded TIL from 26 patients at baseline and on‐treatment. The CD8⁺ TIL population demonstrated a diminished cytokine secretion profile post‐pembrolizumab. Overall, our study assesses the ramifications of one dose of anti‐PD‐1 on TIL in rare solid tumor types.