Sparganosis in the United States. Report of a case

A 20-year-old Philadelphia woman (recently moved from South Carolina) had sparganosis of her lower anterior abdominal wall. In the United States sparganosis occurs when man enters the life cycle of dog or cat tapeworms of the genus Spirometra. Most of the American cases have been reported from the southeastern United States, and the most probable source of infection is contaminated drinking water. Sporadic cases have also been seen in other parts of the country. If the pathologist is familiar with the morphology of spargana, the gross and histologic features are sufficient for identification of genus Spirometra.

Ryanodine receptor type 3 (RYR3) as a novel gene associated with a myopathy with nemaline bodies

BACKGROUND AND PURPOSE

Nemaline myopathy (NEM) has been associated with mutations in 12 genes to date. However, for some patients diagnosed with NEM, definitive mutations are not identified in the known genes, suggesting that there are other genes involved. This study describes compound heterozygosity for rare variants in ryanodine receptor type 3 (RYR3) gene in one such patient.

METHODS AND RESULTS

Clinical examination of the patient at 22 years of age revealed a long narrow face, high arched palate and bilateral facial weakness. She had proximal weakness in all four limbs, mild scapular winging but no scoliosis. Muscle biopsy revealed wide variation in fibre size with type 1 fibre predominance and atrophy. Abundant nemaline bodies were located in perinuclear and subsarcolemmal areas, and within the cytoplasm. No likely pathogenic mutations in known NEM genes were identified. Copy number variation in known NEM genes was excluded by NEM-targeted comparative genomic hybridization array. Next-generation sequencing revealed compound heterozygous missense variants in the RYR3 gene. RYR3 transcripts are expressed in human fetal and adult skeletal muscle as well as in human brain and cauda equina samples. Immunofluorescence of human skeletal muscle revealed a 'single-row' appearance of RYR3, interspersed between the 'double rows' of ryanodine receptor type 1 (RYR1) at each A-I junction.

CONCLUSION

The results suggest that variants in RYR3 may cause a recessive muscle disease with pathological features including nemaline bodies. We characterize the expression pattern of RYR3 in human skeletal muscle and brain, and the subcellular localization of RYR1 and RYR3 in human skeletal muscle.

Transmission of salmonid whirling disease by birds fed trout infected with Myxosoma cerebralis

Mallard ducks, Anas platyrhynchos and a black crested night heron, Nycticorax nycticorax were fed trout infected with Myxosoma cerebralis (HOFER) in 2 separate experiments. Feces from the birds were deposited in troughs containing M. cerebralis-free mud as well as in 1 trough without mud. Spore suspensions were also added directly to mud in 1 trough and to another without mud. Susceptible rainbow trout, Salmo gairdneri, developed whirling disease in all troughs containing mud contaminated with M. cerebralis but remained free of infection when exposed to M. cerebralis in troughs without mud. This demonstrates the possibility of bird transmission of the organism causing whirling disease to previously non-contaminated waters.

Effect of soluble antigen on the ellipsoid-associated cells of the chicken's spleen

The ellipsoid-associated cells (EAC) localize on the surface of the ellipsoid. They bind the IV injected horseradish peroxidase (HRP) and bovine serum albumin (BSA), migrate to the red pulp and then enter the systemic circulation. After protein injection, the number of white blood cells increased above the normal level. The highest number of white blood cells occurred between 4 and 6 hr after HRP injection. In this period, the cell enhancement resulted in HRP-positive mononuclear cells which might come from the spleen. This cell population may vary in size and number in the blood and may be identical with the dendritic cell of the chicken. The other type of blood mononuclear cell is histologically identical with the classical monocyte endogenous peroxidase positive type and their number is lower than that of the former. This type of monocytic (MN) cell could be of bone marrow origin.

Operative closure of patent ductus arteriosus in premature infants in the neonatal intensive care unit

Fifty-two premature infants underwent hemoclip closure of patent ductus arteriosus in the neonatal intensive care unit after a brief trial of fluid restriction and diuretics. Indomethacin was used in only four patients. The median time from diagnosis to operation was 3 days. There were no deaths directly attributable to operation. Nine operative complications developed in nine patients (17 percent). There were no surgical infections. Complications related to prematurity resulted in 20 deaths (38 percent). Patent ductus arteriosus closure in the neonatal intensive care unit prevented the complications of hypothermia, inadvertent extubation, and interruption of vascular access and monitoring. Early operative closure in the neonatal intensive care unit is the treatment of choice in most premature infants with patent ductus arteriosus.

Cardiovascular and behavioral response to social confrontation: measuring real-life stress in the laboratory

Laboratory investigations of cardiovascular reactivity to mental stress often ignore concomitant differences in cognitive, affective, and behavioral responses that are commonly observed among study participants. To provide a more systematic laboratory methodology to examine relations among cardiovascular, behavioral, and self-report measures of cognitive and affective responses to stress, we developed and tested a social confrontation procedure involving standardized interactions during two scenes. Results of three investigations are presented to illustrate the utility of the social confrontation procedure. In the first two studies, this multidimensional assessment strategy produced results which may foster research projects that bridge separate areas of psychological inquiry. In one application, persons with hypertensive parents, in contrast to persons with normotensive parents, exhibited characteristic negative behavioral responses during both interactions as well as the more commonly-observed exaggerated blood pressure reactions. In the other study, students from less functional families (regarding cohesion and adaptability) were shown to exhibit exaggerated blood pressure reactions in addition to their commonly-reported negative cognitive and behavioral coping styles. Finally, a third study examined how a simple instructional set regarding the expression or suppression of anger influenced participants' responses. Significant differences were observed across response domains, with anger expression resulting in a more intense response than anger suppression. In sum, the social confrontation procedure represents an important methodological development for exploring the relation between response domains, the relation between cardiovascular response to stress and psychosocial risk for cardiovascular disease, and the physiological and behavioral distinction between anger expression and anger suppression.

Increased parathyroid hormone-related peptide in patients with hypercalcemia associated with islet cell carcinoma

OBJECTIVE

To report the high prevalence of increased parathyroid hormone-related peptide (PTHrP) in patients with islet cell carcinoma and associated hypercalcemia.

DESIGN

We conducted a retrospective study of PTHrP levels in patients with hypercalcemia and eucalcemia associated with islet cell carcinoma and compared these findings with those in healthy subjects.

MATERIAL AND METHODS

Using a sensitive PTHrP immunochemiluminometric assay, we measured PTHrP levels in 17 patients with islet cell carcinoma and 110 healthy subjects. The differences between PTHrP levels in patients with normal and those with high serum calcium concentrations were analyzed statistically.

RESULTS

PTHrP levels were significantly higher (P < 0.01) in 10 patients with hypercalcemia and islet cell carcinoma (median, 14.0 pmol/L; range, undetectable to 40.1) than in 7 patients with eucalcemia and islet cell carcinoma (median, undetectable; range, undetectable to 1.3 pmol/L) or in the 110 healthy subjects (median, undetectable; range, undetectable to 4.2 pmol/L). The range of increased PTHrP levels in hypercalcemic islet cell carcinoma was 2 to 20 times the upper normal limit (2.0 pmol/L). Decreased PTHrP and serum calcium and increased parathyroid hormone levels were demonstrated in two patients after effective therapy. For all seven eucalcemic patients with islet cell carcinoma, PTHrP levels did not differ significantly from those in healthy subjects.

CONCLUSION

PTHrP levels are increased in a substantial proportion of patients with hypercalcemia and islet cell carcinoma and seem to decrease after treatment of the underlying tumor. Measurement of PTHrP levels may be useful for confirming the diagnosis of hypercalcemia associated with malignant disease and for monitoring of therapy.

A survey of dentitions and removable partial dentures constructed for patients in North America

The prevalence of removable partial dentures in North America is not known. This study was designed to collect information about (1) the indications for, (2) the teeth to be replaced with, and (3) the type of major connectors used in removable partial dentures. Five commercial dental laboratories situated in different regions of North America were selected to give as wide as possible a view of the production of removable partial dentures. Each laboratory was asked to provide details of 300 consecutive removable partial dentures. Photographs (35 mm) of master casts and processed partial dentures were obtained for more than 1300 patients. The color slides were analyzed and the remaining teeth and types of dentures were recorded. The dentures were classified as follows: cast frame denture, acrylic resin denture with or without some wrought metal, and acrylic resin denture with some cast units. The major connectors were classified as one of seven alternatives in the maxillae, and as one of six alternatives in the mandible.

Major histocompatibility (B) complex control of the growth pattern of v-src DNA-induced primary tumors

Observations that the major histocompatibility (B) complex is a determinant of the growth pattern of Rous sarcoma virus (RSV)-induced tumors raised the question as to whether control is exerted at the level of a v-src-determined, i.e., transformation-specific, function. To investigate this point, the tumor size scores and tumor profile indices of v-src-induced tumors were compared in two lines of chickens congenic for B complex genotypes. The finding that the growth patterns of tumors, induced by v-src DNA inoculation at 6 weeks posthatch, differ in these two lines establishes that the B complex exerts control over tumor growth at the level of a v-src-determined function. The potential importance of this control, in terms of the naturally occurring case of an avian sarcoma virus infection, is suggested by the observation that the patterns of tumor growth in a given congenic line are similar whether the tumors are induced by v-src DNA or by RSV.

Dietary arginine influences Rous sarcoma growth in a major histocompatibility B complex progressor genotype

L-Arginine (L-Arg) can serve as a substrate for the production of reactive nitrogen intermediates. One of these metabolites, nitric oxide, has been shown to possess significant antitumor properties in vitro. To investigate the importance of this system in vivo, we have examined the dietary L-Arg host tumor interaction in the chicken. Since chickens are incapable of de novo L-Arg synthesis, concentration of this amino acid is readily controlled by diet. Line UNH 105 New Hampshire chickens having the major histocompatibility complex genotype, B24/B24, were used to study in vivo effects of dietary L-Arg on Rous sarcoma growth. After 5 weeks on a standard diet, 119 chicks were fed either a basal (0.92% L-Arg) diet or a high arginine (2.40% L-Arg) diet. One week later, chicks were wing-web inoculated with subgroup A Rous sarcoma virus. Tumor growth was monitored weekly for 12 weeks after inoculation. Plasma L-Arg levels and body weights from birds on each dietary treatment were analyzed. Neither body weight gains nor latent period for tumor development was affected by diet. However, plasma L-Arg levels were significantly different between dietary treatments (basal, 0.245 +/- 0.01 mumol/ml; high, 0.738 +/- 0.03 mumol/ml). In addition, mean tumor size scores were significantly (P less than 0.05) lower over time in chickens fed the high L-Arg diet. The results suggest that dietary L-Arg in excess of the amount required for growth reduces tumor load.

Multisite Immunochemiluminometric Assay for Simultaneously Measuring Whole-Molecule and Amino-Terminal Fragments of Human Parathyrin

The immunochemiluminometric assay described uses immobilized anti-human parathyrin (parathyroid hormone, hPTH)(1-44) and anti-hPTH(44-68) antisera and acridinium ester-labeled anti-hPTH(1-34) to simultaneously measure both intact hPTH and its amino-terminal fragments. Results by the assay correlate well with those by a cAMP-based bioassay and the Nichols Allegro immunoradiometric assay. The minimal detection limit is 0.08 pmol/L. The normal range is 1.0-5.0 pmol/L, and values are higher in older women. About 90% of study patients with surgically proven parathyroid adenomas had above-normal preoperative PTH concentrations, whereas patients with hypercalcemia of malignancy had normal or suppressed values. This assay was designed to detect both intact PTH and amino-terminal PTH fragments; however, chromatographic fractionation of pools of primary and secondary hyperparathyroid plasma showed virtually no amino-terminal fragment activity. Nonetheless, the design is important because the absence of carboxyl-terminal binding sites prevents interference by carboxyl-terminal fragments and because bioactive amino-terminal fragments will react in the assay if they are present in the patients' sera or if they are produced by in vitro proteolysis of intact PTH.

Differential resistance to Staphylococcus aureus challenge in major histocompatibility (B) complex congenic lines

Ten inbred B-congenic Leghorn lines were challenged with two isolates of Staphylococcus aureus at 3 days and 6 wk of age. Significant differences in mortality were observed among such lines when challenged at 3 days with either S. aureus Isolate P4L (moderately pathogenic) or S. aureus Isolate 3727 (highly pathogenic). Line 331 (B2/B2 genotype) had lower mortality than either Line 004 (B17/B17, chi 2 = 4.13, P < .05) or Line 253 (B18/B18, chi 2 = 4.23, P < .05) challenged with Isolate P4L. The use of a susceptibility index allowed for the detection of additional differences among the various lines challenged by Isolate 3727. Line 336 (BQ/BQ) was more resistant than either Line 335 (B19/B19, P < .01) or Line 330 (B21/B21, P < .01). No significant differences were found among the lines challenged at 6 wk by either isolate. The results provide additional evidence for the importance of the B complex in genetically determined disease resistance, and further demonstrate the usefulness of congenic lines in such investigations.

Antibody response to sheep red blood cells in major histocompatibility (B) complex aneuploid line of chickens

An integral part of the immune response is the production of antibodies specific for different antigenic challenges. Genes of the MHC encode products that regulate immunity. This study utilized the FCT-15 line of chickens, which is aneuploid for the chromosome containing the ribosomal RNA genes (rDNA) and the MHC or B complex to determine whether an antibody response to SRBC would vary as a function of B complex gene dose. Mating of trisomic parents (B15B15B15) animals produced progeny having either a disomic (B15B15), trisomic (B15B15B15), or tetrasomic (B15B15B15B15) B complex dosage. The number of B/rDNA chromosomes, and thus the B complex dosage was determined by feather pulp nucleolar typing of chicks at hatch. A 5% SRBC antigenic challenge, which induces a T cell-dependent antibody response, was injected at 6 wk of age. Samples taken prior to SRBC injection as well as 5, 8, and 12 d postinjection were assayed for total and mercaptoethanol-resistant antibody. Peak antibody titers (log2), day of peak titer and rate of titer decline were calculated using a quadratic equation for each bird. Differences among the three B complex dosages were evaluated by analysis of variance. Antibody titers rose from 5 to 8 d postinjection and declined thereafter without significant differences among the three B complex doses. Calculations from the quadratic equations showed that B complex dose affected neither peak antibody titer nor day of peak titer. However, trisomic and tetrasomic animals had significantly more rapid rates of decline from the maximum titer. In aneuploid chickens, changes in antigen processing, antigen presentation, or persistence of processed antigen may maintain levels of antibody production found in disomic chickens and explain the more rapid decline of titer.

Avian hematopoiesis in response to avian cytokines

The objective of this study was to examine the hematopoietic cell proliferation and differentiation potential of growth factors produced by chicken macrophages. Bone marrow (BM) cells (25 x 10(3)) from newly hatched B15B15 K-strain Leghorn chicks were seeded in .5 mL serum-free semi-solid culture supplemented with 10% (vol/vol) of a conditioned medium (CM) from a chicken macrophage cell line, MQ-NCSU. The conditioned medium was obtained by culturing MQ-NCSU cells either in LM-HAHN (CMI) or RPMI-1640 (CMII) growth medium. The control cultures contained only LM-HAHN or RPMI medium. Bone marrow cells in the presence of CMI differentiated predominately into granulocyte colonies (Experiment 1 = 84 +/- 9.2; Experiment 2 = 105 +/- 5). No colonies were observed in the control cultures. Stimulation of MQ-NCSU cells with lipopolysaccharide (LPS) produced a CM that differentiated BM cells predominantly into macrophage colonies (122 +/- 16.3 in CMI and 92 +/- 5.6 in CMII). These data suggest that MQ-NCSU cells spontaneously secrete a factor with the potential to promote granulocyte differentiation. However, upon stimulation with LPS, the factor secreted had macrophage colony stimulation potential (M-CSF), which was similar in activity when compared with the activity of recombinant chicken myelomonocytic growth factor (r-cMGF). Another CM from chicken fibroblasts (FCM) was tested on BM cells from K-strain Leghorns and Arbor Acres x Arbor Acres broiler chicks. Data from three experiments showed that 25 x 10(3) BM cells from K-strain chicken yielded more macrophage and granulocytes colonies (82 +/- 14) than those from broilers (56 +/- 12). This study suggests that avian cytokines exhibit progenitor cell differentiation potential and that this activity is dependent upon the source of cytokines and their targets.

Glycoconjugates of the intestinal epithelium of the domestic fowl (Gallus domesticus): a lectin histochemistry study

A lectin histochemical study was performed on formalin-fixed paraffin-embedded tissues of duodenum, jejunum, ileum, caecum and colon from six fasted and six non-fasted 8-week-old chickens (Gallus domesticus). The purpose of this study was to identify in situ the pattern of carbohydrate residues present on the luminal surface of the intestinal epithelium. Ten biotinylated lectins with different sugar specificities were used as probes, and avidin-biotin-peroxidase complex (ABC) was used as a 'visualant'. The most significant finding was the binding pattern of Lens culinaris agglutinin to various segments of the intestines. The luminal surface of the small intestinal epithelium did not stain with this lectin. In the colon the luminal surface was lightly stained, while the caecal luminal surface was intensely stained. Throughout the intestine the luminal surface stained with Canavalia ensiformis agglutinin, Ricinus communis agglutinin-I and wheatgerm agglutinin, but it did not stain with Dolichos biflorus agglutinin. These findings indicated that, throughout the intestine, the luminal surface contains glycoconjugates with either N- or O-linked glycoprotein, or both, with terminal non-reducing beta-galactosyl and sialyl residues. Furthermore, the caecal surface is rich in N-linked glycoproteins with an alpha-(1----6)-linked fucosyl residue near the glycosidic linkage. The potential significance of these observations and the role of glycoconjugates in host-parasite interaction (i.e. Eimeria sp. versus Gallus domesticus) are discussed.

Experimental sporotrichosis in Syrian hamsters

Syrian hamsters were infected with Sporothrix schenckii by subcutaneous footpad inoculation. Two types of infection could be uniformly induced: a self-limited, lymphatic infection resembling the classical disease in humans, and a generalized nonfatal infection. An infecting dose of approximately 5,300 yeast cells produced the localized subcutaneous-lymphatic disease which was limited to a single limb. In contrast, a 1,000-fold increase in the inoculum temporarily overwhelmed the animals' defense mechanisms, producing a systemic infection involving the liver and spleen. These models were used to demonstrate the development of increased resistance to subsequent infection following either infection or active immunization with ribosomal fractions or trypsinized cell wall antigens of S. schenckii incorporated in Freund complete adjuvant. Agglutination titers were detectable in all animals that were either infected or immunized. In one group of infected animals, the titers persisted for at least 1 year after three booster doses of Formalin-killed S. schenckii. The ability to produce an infection in hamsters which closely resembles the disease seen in humans makes the animal a good model with which to study experimental sporotrichosis.

TRH receptor binding in retina and pituitary: major species variation

Retinas and anterior pituitary glands of nine readily available mammalian and one avian species have been examined for their TRH-sensitive binding of [3H]-[3-Me-His2]TRH. Among mammals, major species variations in TRH receptor binding have been detected in both tissues, amounting to about 100-fold in the retina and 20-fold in the pituitary. In the retina, TRH receptor binding was very high in the rat, quite high in sheep and guinea pig, intermediate in rabbit, pig, and mouse, and low but detectable in chicken, cat, calf and dog. In the pituitary gland, binding was very high in sheep, quite high in rabbit, rat, pig, calf and guinea pig, intermediate in chicken, and fairly low in mouse, cat, and dog. A number of possible interfering variables, including affinity differences, albino vs. non-albino strains, barbiturate anesthesia, time after death, sex and estrous cycle, age, and history of light exposure, were considered and/or tested directly, with generally negative results.

Major histocompatibility (B) complex-associated differences in the delayed wattle reaction to staphylococcal antigen

The influence of the major histocompatibility (B) complex on the delayed wattle reaction (DWR) to Staphylococcus aureus was studied in 109 segregants (B2/B2, B2/B5, and B5/B5) of a fourth generation cross between inbred Regional Poultry Research Laboratory lines 6(1) and 15(1). Chickens were sensitized at 6 weeks of age with S. aureus antigen. One week later, DWR was evaluated by injecting the right wattle with S. aureus antigen. Thickness measurements were taken 4, 24, 48, 72, and 96 hr after injection. A quadratic equation model was used for each bird to calculate maximum wattle thickness, hour of maximum response, and rate of response development and decline. In males, the maximum wattle thickness in response to S. aureus antigen was significantly greater in B2/B5 heterozygotes (1.77 +/- .07 mm) than in either homozygote, B2/B2 (1.36 +/- .13 mm) or B5/B5 (1.39 +/- .08 mm). Heterozygous males reached maximum response sooner and recovered more quickly than homozygous males but these differences were not statistically significant. In females, response developed later than in males but no B complex effect was detected in either rate of development or maximum response.

Promoting social support: the impact of California's "Friends Can Be Good Medicine" campaign

Increasing recognition of the importance of social support for health has not been accompanied by commensurate increases in knowledge about how to strengthen natural support networks on a large scale. This study evaluated the impact of California's innovative "Friends Can Be Good Medicine" public education campaign in promoting social support. Campaign impact was assessed with pre-, post-, and long-term follow-up interviews with a panel sample of 340 adults in the six county Fresno media market area. Comparisons of exposed and unexposed individuals found that the campaign appeared to have measurable impact on knowledge, attitudes, behavioral intentions, and support enhancing behavior. Follow-up interviews indicated that these gains maintained themselves over the course of a year. The campaign was most effective when it utilized multiple channels of communication. In Fresno City, where there was the most intensive combination of community activities and media exposure, respondents indicating substantial likelihood of engaging in support enhancing behavior increased from 42% to 59% compared to smaller gains in areas which relied primarily on community implementation, and no gains in areas where exposure to the campaign was limited to mass media. The campaign appeared particularly effective with people who had experienced the death of someone close to them during the past year, and within that group, gains were largest among respondents below average in initial levels of social support.