Persistent itching nodules after the fourth dose of diphtheria–tetanus toxoid vaccines without evidence of delayed hypersensitivity to aluminium

Studies in Gothenburg, Sweden, reported an exceptionally high rate of persistent itching nodules at the site of injection of aluminium containing vaccines, usually with positive epicutaneous tests to aluminium. When a new booster diphtheria-tetanus vaccine was introduced we performed a prospective cluster randomised active surveillance in 25,232 10-year-olds. Parental reports 6 months after vaccination with Duplex or diTeBooster were collected for 22,365 (88%) pupils in 851 schools. We identified 3-6 children per 10,000 with a local itching nodule persisting for at least 2 months. There were no significant differences between the vaccine groups. Contact allergy to aluminium was not detected. The findings support the use of the vaccine presently available in the Swedish vaccination program. Continued surveillance of persistent itching nodules and aluminium contact allergy is, however, warranted for vaccines containing pertussis toxoid and aluminium.

Retained heterodisomy for chromosome 12 in atypical lipomatous tumors: implications for ring chromosome formation

Atypical lipomatous tumor (ALT) is an intermediate malignant mesenchymal tumor that is characterized by supernumerary ring chromosomes and/or giant rod-shaped marker chromosomes (RGMC). Fluorescence in situ hybridization (FISH) and molecular genetic analyses have disclosed that the RGMCs always contain amplified sequences from the long arm of chromosome 12. Typically, RGMCs are the sole clonal changes and so far no deletions or other morphologic aberrations of the two normal-appearing chromosomes 12 that invariably are present have been detected. The mechanisms behind the formation of the RGMCs are unknown, but it could be hypothesized that RGMC formation is preceded by trisomy 12 or, alternatively, that ring formation of one chromosome 12 is followed by duplication of the remaining homolog. The latter scenario would always result in isodisomy for the two normal-appearing chromosomes 12, whereas the former would yield isodisomy in one-third of the cases. In order to investigate these possible mechanisms behind ring formation, we studied polymorphic loci on chromosome 12 in 14 cases of ALT showing one or more supernumerary ring chromosomes and few or no other clonal aberrations at cytogenetic analysis. The molecular genetic analyses showed that the tumor cells always retained both parental copies of chromosome 12, thus refuting the trisomy 12 and duplication hypotheses.

Epoxy-based production of wind turbine rotor blades: occupational dermatoses

Occupational dermatoses were investigated in a factory producing rotor blades for wind turbines by an epoxy-based process. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch tested with a specially profiled occupational patch-test series and the European standard patch-test series. Calculated on all investigated workers, 17.1% of the workers were diagnosed with occupational dermatoses caused by work. Occupational allergic contact dermatitis was found in 10.9% of the workers. The estimated frequency of irritant contact dermatitis caused by work was 6.1%. Dermatitis on the hands was associated with contact allergy to epoxy resin (P = 0.017). The number of days on leave before the clinical examination was negatively associated with the presence of dermatitis (P = 0.001). Among workers employed 7-12 months, the frequency of occupational contact allergy was higher than that among workers employed for </=6 months (P = 0.004). Females both washed their hands more often (P < 0.001) and used more moisturizers/protection creams at work (P < 0.001) than males. No sex differences were found concerning dermatitis on the hands.

Hydrothermal treatment and malting of barley improved zinc absorption but not calcium absorption in humans

OBJECTIVE

To study whether hydrothermal treatment or malting of barley (cv. Blenheim) improves zinc and calcium absorption in humans.

DESIGN

: Two groups of 10 and 12 healthy subjects, respectively, were in a period of 2 months in a fasting state, served two single meals each containing porridge or breakfast cereals prepared from processed or unprocessed (control) barley (60 g). The meals included 200 g of milk, extrinsically labelled with (65)Zn and (47)Ca. Whole-body retention of both minerals was measured.

SETTING

The study was carried out at the Department of Radiation Physics, Sahlgrenska University Hospital, Göteborg.

SUBJECTS

The subjects were recruited among students at the Göteborg University. None dropped out.

INTERVENTIONS

The activities of (65)Zn and (47)Ca were measured by whole-body counting four to five times over a 4-week period after each meal.

RESULTS

Zinc absorption from hydrothermally treated barley porridge, containing 28 mg P as inositol tri- to hexaphosphates (InsP(3)-InsP(6)), was significantly higher (P<0.001) than from control porridge containing 111 mg P as InsP(3)-InsP(6), 25.2+/-6.9 vs 11.0+/-2.5% (n=12). Calcium absorption did not differ (P>0.05), 21.1+/-6.8 vs 19.5+/-4.7% (n=12). Zinc absorption from breakfast cereals of malted barley with phytase activity and containing 70 mg P as InsP(3)-InsP(6,) was significantly higher (P<0.05) than from flakes of barley, containing 108 mg P as InsP(3)- InsP(6) and no phytase activity, 22.9+/-5.8 vs 14.8+/-4.6% (n=10). The calcium absorption was 21.3+/-6.5 vs 18.5+/-4.3% (n=10) and did not differ significantly (P>0.05).

CONCLUSION

Improvements of zinc absorption in breakfast meals can be achieved by optimised hydrothermal treatment or malting of barley. Calcium absorption was not influenced in the meals in this study.

SPONSORSHIP

Supported by Semper AB, Sweden, Oy Lahden Polttimo, Finland, the SL-Foundation, Sweden, Swedish National Board for Industrial and Technical Development (NUTEK), the Nordic Industrial Foundation, Swedish Council for Forestry and Agricultural Research (SJFR, project no 50.0306/97).

Determination of potassium in the skeletal muscles by whole-body counting

Changes in muscular function are related to nutritional status, disease and physical activity. To study these relationships, it is desirable to be able to determine the whole body potassium content, which is characteristic to the muscular tissue. This can be achieved by measurements in a whole-body counter, identifying contributions from the upper and lower parts of the body. In a whole-body counter with large plastic scintillators, a special measuring methodology is required. Such a method of measuring (40)K in the leg muscles, extracting the part of the detector signal originating from the lower part of the body, has been developed and tested by independent phantom measurements. The results suggest that it is suited to perform regional measurements of body potassium but validation and implementation into clinical research are still necessary.

X-ray fluorescence analysis in medical sciences: a review

Some elements have toxic effects on the human body and there is thus a need to control their levels in human organs and tissues. Moreover, it is important to increase our knowledge of relationships between observable toxic effects and element concentrations in man and his environment. Monitoring and basic occupational and environmental research rely on measurements directly in humans as well as samples from humans and the environment. This paper reviews recent advances in in vivo X-ray fluorescence methods and their applications.

Effects of sex steroids on survival and receptor expression in ovarian epithelial tumour cells

The factors that govern the genesis and progression of ovarian cancer remain unclear. It is thought that ovarian tumours are endocrine related and hormone dependent. We therefore investigated the effects of the sex steroids progesterone, testosterone and 17 beta-estradiol on tumour cell survival and the expression of estrogen receptors (ER) and progesterone receptors (PR) in tumour cells. The study was performed on primary cell cultures derived from patients suffering from epithelial ovarian cancer. The majority of the cells isolated expressed ER and PR to some degree, the combination ER+/PR+ was the most common. Both ER and PR expression decreased after 72-h culture, revealing an unexpectedly dynamic system. The survival rates of cells cultured in progesterone seemed to be inversely related to their PR expression. Lowering levels of 17 beta-estradiol and testosterone in cell cultures reduced cell survival, but it appears that this observation depends on factors other than ER.

Low sex steroid environment affects survival and steroid secretion of ovarian tumour cells in primary cultures

Ovarian epithelial tumours are considered to be endocrine related. The effects of an environment with low levels of the steroid hormones 17 beta-estradiol, testosterone or progesterone on cell survival and steroid secretion were studied in primary cell cultures derived from 25 patients suffering from epithelial ovarian tumours. Tumour cells cultured in 17 beta-estradiol and testosterone showed a reduced cell survival (-10.3 +/- 2.3% and -15.6 +/- 2.7% minimum survival respectively). This reduction was inversely proportional to hormone concentrations within the range studied. No similar effect was observed in the progesterone cultures. It was found that 17 beta-estradiol was secreted from the primary cell cultures and, interestingly, the amount of 17 beta-estradiol secreted increased with increasing levels of 17 beta-estradiol in the environment. Neither progesterone nor testosterone production was observed in any of the cultures studied. It is believed that 17 beta-estradiol has an antiapoptotic effect on ovarian surface epithelial (OSE) cells. Reduction of 17 beta-estradiol in the environment may inhibit this effect, resulting in reduced cell survival. The ability of ovarian epithelial tumour cells to secrete 17 beta-estradiol suggests that epithelial ovarian tumours play an active role in altering their own hormonal environment, promoting tumour progression.

Fusion of the BCR and the fibroblast growth factor receptor-1 (FGFR1) genes as a result of t(8;22)(p11;q11) in a myeloproliferative disorder: the first fusion gene involving BCR but not ABL

Constitutive activation of tyrosine kinases as a consequence of chromosomal translocations, forming fusion genes, plays an important role in the development of hematologic malignancies, in particular, myeloproliferative syndromes (MPSs). In this respect, the t(9;22)(q34;q11) that results in the BCR/ABL fusion gene in chronic myeloid leukemia is one of the best-studied examples. The fibroblast growth factor receptor 1 (FGFR1) gene at 8p11 encodes a transmembrane receptor tyrosine kinase and is similarly activated by chromosomal translocations, in which three alternative genes-ZNF198 at 13q12, CEP110 at 9q34, and FOP at 6q27-become fused to the tyrosine kinase domain of FGFR1. These 8p11-translocations are associated with characteristic morphologic and clinical features, referred to as "8p11 MPS." In this study, we report the isolation and characterization of a novel fusion gene in a hematologic malignancy with a t(8;22)(p11;q11) and features suggestive of 8p11 MPS. We show that the breakpoints in the t(8;22) occur within introns 4 and 8 of the BCR and FGFR1 genes, respectively. On the mRNA level, the t(8;22) results in the fusion of BCR exons 1-4 in-frame with the tyrosine kinase domain of FGFR1 as well as in the expression of a reciprocal FGFR1/BCR chimeric transcript. By analogy with data obtained from previously characterized fusion genes involving FGFR1 and BCR/ABL, it is likely that the oligomerization domain contributed by BCR is critical and that its dimerizing properties lead to aberrant FGFR1 signaling and neoplastic transformation.

Skin reactions to inhaled corticosteroids

Corticosteroids intended for inhalation into the lungs or into the nose have been used since the 1970s. Only 2 attempts to assess contact allergy attributable to inhaled corticosteroids in patients with asthma and/or rhinitis have been made, and only 1 single case of contact allergy attributable to budesonide and tixocortol pivalate was found. However, several case reports of allergic mucosal and skin symptoms caused by corticosteroids applied locally to the mucosa have been published. Local adverse effects from nasal corticosteroids have ranged from nasal congestion, pruritus, burning, and soreness to perforation of the nasal septum. Inhalation of corticosteroids into the lungs has been reported to cause pruritus, dryness, erythema and oedema of the mouth, a dry cough and odynophagia. Systemic signs reported from the use of nasal corticosteroids and inhalation of corticosteroids into the lungs have been eczematous lesions, particularly on the face, sometimes with spreading to the trunk and flexures. Urticaria has also been noted.