The cost-of-illness for invasive meningococcal disease caused by serogroup B Neisseria meningitidis (MenB) in Germany

Introduction

Invasive meningococcal disease (IMD) is a severe disease mainly affecting infants and young children. The most common serogroup causing IMD in Germany is the serogroup type B Neisseria meningitidis (MenB). The aim of the present study is to estimate the economic burden of MenB-related IMD in Germany.

Nucleotide levels in human and bovine lenses: a study on regional postmortem changes

Regional lens adenine nucleotide levels were determined in human and bovine lenses using sensitive HPLC techniques. In adult lenses of both species adenine nucleotide levels were highest in the anterior cortex (plus epithelium and capsule) followed by the posterior cortex (plus capsule) and lowest in the nucleus. With increasing lens age ATP level remained steady in the anterior cortex (plus epithelium and capsule) and nucleus, while those in the posterior cortex showed a tendency toward decrease. In both species, human as well as bovine, adenine nucleotide levels of the anterior cortex (plus epithelium and capsule) underwent early postmortem changes. Thus, immediate postmortem sampling as well as regional determinations are a must for detailed studies of lens nucleotide metabolism.     

Multiclefted nuclei. A helpful feature for identification of intermediate trophoblastic cells in uterine curetting specimens.

Intermediate trophoblast is a distinct form of trophoblast, the presence of which in uterine curettings is considered a reliable indicator of intrauterine pregnancy even in the absence of chorionic villi. However, the appearance of intermediate trophoblastic cells have not been described in sufficiently specific terms to permit their reliable identification, and distinction from decidual cells can be difficult. We have noticed for some time that the intermediate trophoblastic cells often show multiple deep clefts in the nuclei, and the present study was performed to address the issue of whether this nuclear feature is reliable for their identification. We reviewed 242 uterine curettings of intrauterine pregnancy, documented by the presence of chorionic villi, and were able to find a distinct population of cells with large, hyperchromatic, multiclefted nuclei scattered in the decidua in 88% of the cases. In most instances, these cells produced a characteristic variegated pattern that was readily recognizable at low magnification. Positive immunostaining for cytokeratin (CAM 5.2) in these isolated cells within the decidua confirmed their trophoblastic nature. In contrast, multiclefted nuclei were absent in the 51 negative control cases, which included decidualized endocervical polyps (40 cases), uterine curettings from patients with tubal pregnancy (10 cases), and endometriosis with decidual change (one case). We conclude that intermediate trophoblastic cells can usually be reliably identified in curettings of intrauterine pregnancy by their characteristic nuclear multiclefting.     

Acute phase response following total hip replacement and in patients with aseptic loosening]

INTRODUCTION: Aseptic loosening is a result of the chronic inflammatory reaction in periprosthetic tissues. Its intensity depends on the implants construction material and reactivity of the host's tissues. The aim of the study was the evaluation of the acute phase proteins in various periods following total hip replacement and comparison between acute phase response observed in patients with well-functioning implants and with aseptic loosening. MATERIAL: The study group consisted of 97 patients following THR due to the hip osteoarthritis. Patients of Group I were evaluated before the surgery and 6 months after primary THR. Group II consisted of patients 3-4 years after primary THR. Group consisted of patients with aseptic loosening. Patients of all groups were divided according to the implant type (cemente/uncemented). METHODS: Concentrations of evaluated acute phase proteins: C-reactive protein (CRP), transferrin (Tf) and alpha-glycoprotein were assessed using immunoelectrophoresis. RESULTS: In vast majority of patients (71-95%) following THR had present w3 variant of AGP which should be negative in physiological conditions. The average concentrations of AGP and AGP-RC were higher in patients following cemented THR. CONCLUSIONS: Implantation of the endoprosthesis raises a chronic inflammatory reaction expressed by changes in the profiles of acute phase proteins. This process is more visible in patients following cemented THR. The profiles of the acute phase proteins in patients with aseptic loosening were not different than those observed in patients with well-functioning implants, what makes them useless as a diagnostic tool for loosening. This lack of differences may be caused by adaptation of the generalised response to long lasting process of aseptic loosening     

Production and characterization of highly specific anti-methotrexate monoclonal antibodies

Spleen cells of a Biozzi HR mouse immunized with a bovine serum albumin-methotrexate conjugate were fused with P3-X63-Ag8.653 mouse myeloma cells. Twenty-three monoclonal antibodies (MAbs), selected by indirect ELISA, were produced and partially characterized. Using methotrexate (MTX) and eight structurally related compounds, binding specificities of the MAbs were assessed by inhibition enzyme immunoassay. All the MAbs had very low affinity for folic acid and its analogs and for the major MTX metabolite 7-hydroxymethotrexate. Using a computer cluster analysis program based on the binding specificities, the MAbs were divided into three groups. The thirteen MAbs in group I recognized primarily the pteridine portion of the MTX molecule; the eight group II MAbs recognized the benzene ring as well as the pteridine structure. The two MAbs in group III poorly distinguished between the different parts of the MTX molecule. The apparent equilibrium association constants of the anti-MTX MAbs in groups I, II, and III ranged from 7 x 10(9) to 3 x 10(8) M-1 (except for 1 MAb), from 5 x 10(7) to 6 x 10(6) M-1 (except for 2 MAbs), and from 1 x 10(6) to 3.5 x 10(5) M-1, respectively.     

A table of senile forms of cataract. Clinical picture, prognosis, biochemistry and etiology

The three important types of age-related senile cataract, namely deep supranuclear cortical cataract, superficial subcapsular cortical cataract (sometimes associated with secondary nuclear cataract), and primary nuclear cataract, are arranged in a table which may be used for quick reference with regard to clinical features - slit lamp findings, age at onset of opacification, rate of progression, and related biochemistry (e.g., ATP content, glutathione content, and the cation pump (K+ greater than Na+] - as well as etiological features. The significance of the table is illustrated on the basis of an important example from the literature ("Sunlight and Human Cataracts").     

Purified 60-kilodalton Legionella protein antigen with Legionella-specific and nonspecific epitopes.

In a previous study, all convalescent-phase sera from patients with culture-confirmed legionellosis reacted on immunoblots with a Legionella genus-wide 58-kilodalton (kDa) protein antigen (J.S. Sampson, B.B. Plikaytis, and H.W. Wilkinson, J. Clin. Microbiol. 23:92-99, 1986). The present study was done to immunologically characterize and determine the diagnostic relevance of this purified antigen. The antigen was precipitated from enriched cell extracts with ammonium sulfate and purified by high-pressure liquid chromatography. High-titered rabbit antiserum produced to the purified protein was used to show its presence on immunoblots in the 60-kDa range in 38 Legionella serogroups, representing 23 species, and in 39 non-Legionella bacteria. The antiserum was made specific for Legionella strains by sequential absorptions with Bordetella pertussis, Pseudomonas aeruginosa, and Pseudomonas fluorescens whole cells. Serum from legionellosis patients reacted with both specific and nonspecific epitopes. Results of indirect immunofluorescence experiments showed that neither specific nor nonspecific epitopes of the 60-kDa protein were surface exposed on Legionella cells and that cross-reactive epitopes were variably exposed on non-Legionella bacteria. The 60-kDa protein antigen should be useful in diagnostic tests for legionellosis if care is taken to expose cryptic epitopes and if the tests use or measure only the Legionella-specific epitopes.     

The Topography of Non-Linear Cortical Dynamics at Rest, in Mental Calculation and Moving Shape Perception

Differential cortical activation by cognitive processing was studied using dimensional complexity, a measure derived from nonlinear dynamics that indicates the degrees of freedom (complexity) of a dynamic system. We examined the EEG of 32 healthy subjects at rest, during a visually presented calculation task, and during a moving shape perception task. As a nonlinear measure of connectivity, the mutual dimension of selected electrode pairs was used. The first Lyapunov coefficient was also calculated. Data were tested for non-linearity using a surrogate data method and compared to spectral EEG measures (power, coherence). Surrogate data testing confirmed the presence of nonlinear structure in the data. Cognitive activation led to a highly significant rise in dimensional complexity. While both tasks activated central, parietal and temporal areas, mental arithmetic showed frontal activation and an activity maximum at T3, while the moving shape task led to occipital activation and a right parietal activity maximum. Analysis of mutual dimension showed activation of a bilateral temporal-right frontal network in calculation. The Lyapunov coefficent showed clear topographic variation, but was not significantly changed by mental tasks (p<.09). While dimensional complexity was almost unrelated to power values, nonlinear (mutual dimension) and linear (coherence) measures of connectivity shared up to 37% of variance. Data are interpreted in terms of increased cortical complexity as a result of recruitment of asynchronously active, distributed neuronal assemblies in cognition. The topography of nonlinear dynamics are related to neuropsychological and neuroimaging findings on mental calculation and moving shape perception.