Inhibition of respiratory virus infections of mice with aerosols of synthetic double-stranded ribonucleic Acid

Aerosols of double-stranded complexes of polyinosinic and polycytidylic acids (poly I:C) were useful in protecting mice infected with aerosols of influenza (A(2)/Taiwan/64) and parainfluenza type 1 (Sendai) viruses. Administration of poly I:C as an aerosol offers an advantage, particularly in therapy, by eliminating the risk of pulmonary dissemination of viral infections due to intranasally instilled fluids. Treatment of mice with aerosols of poly I:C reduced the infection rate with influenza virus but did not inhibit virus multiplication in the lungs of most of those animals where infection became established. Sendai virus infection rates were undiminished in mice treated with poly I:C, but lung-virus titers were significantly suppressed as compared with those of untreated animals. The maximum poly I:C doses (40 mug) administered by aerosol produced no evidence of toxicity in the mice.

Deletion of the CUL4B gene in a boy with mental retardation, minor facial anomalies, short stature, hypogonadism, and ataxia

The CUL4B gene encodes a member of Cullin-RING ubiquitin ligase complex. Point mutations in CUL4B were identified recently in patients with syndromic X-linked mental retardation (XLMR). Here, using oligoarray-based comparative genomic hybridization (array CGH), we identified a de novo deletion of the CUL4B gene in a boy with syndromic mental retardation, minor facial anomalies, short stature, delayed puberty, hypogonadism, relative macrocephaly, gait ataxia, and pes cavus, all manifestations described previously in patients with CUL4B point mutations. Interestingly, our patient also presented with aortic valvular "dysplasia" and vertebral anomalies similar to those seen in Scheuermann disease, both of which may also be part of this syndrome. This report further suggests that point mutations and deletions of the CUL4B gene lead to a recognizable phenotype. The association of facial anomalies, short stature, hypogonadism, and gait ataxia in a mentally retarded boy should prompt molecular analyses of the CUL4B gene.

Familial frameshift SRY mutation inherited from a mosaic father with testicular dysgenesis syndrome

CONTEXT

The SRY gene encodes a transcription factor responsible for initiating testis differentiation. Mutations in SRY almost always result in XY sex reversal with pure gonadal dysgenesis and an increased risk of gonadal tumor. Most of these mutations are de novo, affecting only one individual in a family. Only a small subset of mutations is shared between a phenotypically normal father and one or more of his affected children. Incomplete penetrance and somatic mosaicism are two hypotheses that may explain a normal phenotype in a father carrying a SRY mutation.

PATIENTS AND RESULTS

We describe a family with two sisters with XY sex reversal and pure gonadal dysgenesis and a phenotypically normal brother. A novel constitutional frameshift SRY mutation was identified in both sisters and was absent in the brother. The single base pair deletion (c.71delA) led to a premature stop codon in position 60 of the protein, removing entirely the high-mobility group domain and the DNA-binding domain of SRY. The father of the three children presented with hypospadias; cryptorchidism; testicular seminoma and oligoasthenozoospermia, an association termed testicular dysgenesis syndrome (TDS); and the SRY mutation in a mosaic state in the peripheral blood and the tumor.

CONCLUSIONS

This observation of somatic and germinal mosaicism for a SRY mutation may explain the variable penetrance in some familial gonadal dysgenesis. Importantly, the present report is the first one describing the association of SRY mutation in a male with TDS. This suggests that mutations in a sex-determining gene may contribute to the pathogenesis of TDS.

Disorders of functions and disorders of capacity in relation to sick leave in mental disorders

BACKGROUND

With the publication of the International Classification of Functioning, Disability and Health (ICF), the description of functional health as opposed to symptoms of illness has gained in importance.

AIMS

To study the interrelation between disorders of functions, capacity and participation in mental disorders.

METHOD

Two hundred and thirteen psychosomatic inpatients were assessed with the Mini-ICF-Rating for Mental Disorders (Mini-ICF-P), the Symptom Checklist (SCL-90-R) and an interview on sick leave.

RESULTS

The highest scores in the Mini-ICF-P were found for 'flexibility' (M = 1.64, SD = 0.94), 'structuring of tasks' (M = 1.12, SD = 1.05) and 'endurance' (M = 1.12, SD = 1.02), the lowest for 'self maintenance' (M = 0.19, SD = 0.44), 'mobility' (M = 0.43, SD = 0.85) and 'adherence to regulations' (M = 0.74, SD = 0.98). The correlation between Mini-ICF-P and SCL-90-R GSI is r = 0.51 (p < 0.001), between sick leave and GSI is r = -0.05 and between sick leave and Mini-ICF-P r = 0.34 ( p < 0.001).

CONCLUSION

Disorders of capacity are more closely related to disorders of participation/sick leave than disorders of functions.

Estrogen and antiestrogen-dependent regulation of breast cancer cell proliferation in multicellular spheroids: Influence of cell microenvironment

Multicellular tumor spheroids, an in vitro 3-D model that simulates malignant-cell contacts within a tumor, can be used to evaluate tumor response to therapeutic agents. We found that MELN (derived from MCF-7 cells) cells grown in 3-D as spheroids, remain highly sensitive to estradiol in terms of growth, down-regulation of ERalpha expression and ERalpha-induced transcriptional activity. Estradiol induces cyclin D1 and CDK1 proteins in Ki-67 positive proliferating cells, whereas survivin is up-regulated in both Ki-67 positive proliferative outer layer of cells and around the necrotic zone in non-proliferating cells. OH-Tam inhibits both estradiol-induced transcriptional activity and estradiol-dependent growth of MELN spheroids. Consistent with its antiproliferative effect, we observed that OH-Tam induces an important decrease in the proportion of proliferating cells, positive for Ki-67, cyclin D1 and CDK1. But, in contrast to what was expected, OH-Tam treatment resulted in a decrease in the proportion of p21 positive cells. Furthermore, despite its ability to down-regulate survivin in MELN spheroids, OH-Tam did not trigger apoptosis. Taken together, these results indicate that this model, is more relevant to an in vivo situation than monolayer cultures. It could be useful to identify new markers of the response to endocrine treatment and to investigate the effects of drugs combination.

[Contribution of the laboratory in hypoglycemia diagnosis induced by insulin administration in a 2-year-old girl]

We report the case of a 2 year-old child presented to the emergency department following a seizure. The child was hypotonic and examination was unremarkable but laboratory tests confirmed a severe hypoglycaemia. The insulin level, inappropriately high for the glycemia and the peptide C undetectable suggested exogenous hyperinsulinism. We conclude that the hypoglycaemia was likely the result of Munchhausen syndrome by proxy. The specificity of two immunoassays used (Elecsys Roche and IRMA CisBio) for the synthetic analogues of insulin explains the discrepancy between the insulin levels obtained but was crucially useful to the approach of the cause of the hypoglycaemia.

Vibrio cholerae in the environment: a simple method for reliable identification of the species

A simple screening and identification protocol was assessed for the efficient distinction of colonies of Vibrio cholerae species from others obtained on thiosulphate citrate bile salts sucrose agar after isolation from different environmental specimens. It was demonstrated here that the yellow colonies (sucrose-fermenting), which are able to grow on nutrient agar without added NaCl and which present a positive oxidase reaction, can be confidently considered as presumptive V. cholerae. Confirmation of the identification was carried out using the API 20E microtest and by species-specific ompW-based polymerase chain reaction: 809 of 925 isolates obtained by this screening procedure were identified as V. cholerae by API 20E and confirmed by PCR. The results showed that the direct use of the PCR-based method for the definite identification of the screened colonies gave better results than the API 20E method: of a selection of 100 isolates presumptively identified as V. cholerae according to the proposed screening procedure, all gave a positive result with PCR but only 94 were confirmed by API 20E. This protocol provides reliable identification of V. cholerae species and is adapted to the capabilities of routine clinical, food-testing and environmental microbiology laboratories.

Pertussis surveillance in French hospitals: results from a 10 year period

We present 10 years of results from a paediatrician hospital network surveillance in France, set up in 1996 to monitor the trend of pertussis (whooping cough) in children and the impact of the vaccination strategies. Microbiologists from 43 hospitals that participate in the network on a voluntary basis notify pertussis diagnosis, and paediatricians complete a questionnaire for the infants under 6 months that fulfil the microbiological, clinical or epidemiological case definition. The network covers about 30% of pertussis cases seen in French hospitals.

Effectiveness of childhood vaccination against rotavirus in sub-Saharan Africa: The case of Nigeria

Rotavirus diarrhoea is associated with high childhood mortality in developing countries. A new vaccine was recently licensed in Mexico. The objective of this study was to assess the effectiveness of routine childhood vaccination by this new vaccine in a developing country. We constructed a decision tree to compare two alternatives: "no vaccination programme" and "vaccination programme". The estimates used for disease incidence, vaccine efficacy and coverage rates were derived from published data. We followed a hypothetical Nigerian cohort from birth to age five. The vaccine programme would prevent 284,000 cases of rotavirus diarrhoea annually and 6129 deaths due to the disease. In this study in a sub-Saharan country, we showed that rotavirus vaccination with a new vaccine substantially reduces the number of deaths from rotavirus diarrhoea and may be of great use in developing countries.

Dispersion of heavy metals (metalloids) in soils from 800-year-old pollution (Mont-Lozère, France)

Numerous palaeo metallurgical sites (n = 70) characterized by slag presenting a homogeneous typology have been reported on the Mont-Lozère Massif (Southern France). These activities took place in the medieval period. The silicated slag matrix comprises mainly Pb (25%), Sb (0.4%), and several thousand parts per million of As, Cu, and Zn. Soil samples were collected in and around two sites, to understand the dispersion mechanism affecting the slag tailings through use of metal concentrations and lead isotopic compositions. The majority of polluted soil samples show high enrichment factors (EF) for Pb and Sb, slightly lower EFs for Cu, and much lower EFs for As and Zn. We show that this "old" metal pollution was physically dispersed, through erosion of workshop soils and slag tailings, in a restricted area (ca. 200 m down slope form the site). There is no evidence for massive leaching of slag metals by soil waters, except for Zn. Thus, the pollution is mainly due to the metal-making process, i.e., smoke-fallout, pieces of ore, the crackling of smelting ore outside the oven during reduction, and charcoal, etc. The lead isotopic compositions of the soils define a binary mixing trend between local granite or background soil and slag (which represent the workshop soil). Simple mass balance equations using either Pb isotopes or Pb concentrations suggest that between 40 and 100% of the total Pb in soils comes from the Medieval workshop pollution, leaving any later pollution negligible. The large number of sites on the Mont-Lozère means this medieval pollution is significant and poses a real environmental risk.

Transient or occult HIV infections may occur more frequently than progressive infections: changing the paradigm about HIV persistence

Evidence of transient HIV infections was found in 8 subjects at high-risk for HIV infection among 47 longitudinally studied over 2-5 (average approximately 3.5) years, whereas only two subjects developed progressive infection. All of these subjects developed serum antibodies (Ab) to conformational epitopes of HIV gp41 (termed "early HIV Ab"), but the 8 transiently infected subjects lost this Ab within 4-18 months, and did not seroconvert to positivity in denatured antigen EIA or Western Blot (WB). However, the two progressively infected subjects eventually seroconverted in the EIA and WB tests within one to two months after the appearance of "early HIV Ab". HIV env and nef sequences were directly PCR amplified from the peripheral blood mononuclear cells (PBMCs) of two of the eight transiently infected subjects during the time of "early HIV Ab"-postivity, and these showed significant sequence divergence from the HIV strains in the laboratory, indicating that they were not laboratory contaminants. Genome identity typing ("paternity-typing") of PBMC samples obtained at the time of "early HIV Ab"-positivity, and later when Ab was absent from each of the 8 subjects, showed that blood samples were not mixed-up. This provides further evidence that transient or occult infection with HIV does occur, and perhaps at a greater frequency than do progressive infections.

[Morbidity and cost of rotavirus infections in France]

BACKGROUND

Rotavirus is the most common cause of severe diarrhea in children. Morbidity and mortality related to rotavirus infection is not well known in temperate countries in general, and in France in particular.

OBJECTIVES

The aim of this study was estimate the morbidity, mortality, and cost related to the rotavirus infection in France, in order to assess the potential impact of a vaccination program.

METHODS

A birth cohort was followed until 5 years of age using a decision tree model. Rotavirus infection incidence rates were modeled according to age, seasons, and breast-feeding status.

RESULTS

Based on estimates from a decision model, we found that in France, rotavirus infection was responsible for 300,000 annual episodes of acute diarrhea, 138,000 visits to general practitioners, 18,000 hospitalizations, and 9 deaths. The annual direct cost related to rotavirus infection care was estimated at 28 million euros.

CONCLUSION

This study demonstrates the high morbidity and cost of care associated with rotavirus infection in France. The decision tree model developed in this study could be used in the future to estimate the potential effectiveness, cost and cost-effectiveness of childhood vaccination strategies using new rotavirus vaccines.

[Hypoglycemia associated with oral sulfonylurea hypoglycaemic agents in an 11-year-old girl]

In children more than 8 years old, hyperinsulinism is the most common cause of hypoglycemia.

CASE REPORT

We report the case of an 11-year-old girl who presented recurrent hypoglycemia with endogenous hyperinsulinism (high insulin and C-peptide concentrations). The morphological investigations didn't find insulinoma. Finally the questioning identifies the voluntary intoxication with hypoglycemic agent. At a later date, the sulfonylurea dosage during an hypoglycaemic episode was positive.

CONCLUSION

The sulfonylurea drugs can mimic an endogenous hyperinsulinism and mislead the diagnostic to an insulinoma suspicion and lead to a surgical exploration. A sulfonylurea dosage should be done before planning out surgery.

Record of metal workshops in peat deposits: history and environmental impact on the Mont Lozère Massif, France

This study aims to document the history of the metallurgical activities on the Mont Lozère massif in the Cévennes Mountains in Southern France. Many medieval sites of metallurgical wastes (slags) have been reported on the massif. These sites are thought to represent ancient lead workshops. The impact of past metallurgical activity on the environment was studied using geochemical and palynological techniques on a core collected in the Narses Mortes peatland near medieval smelting area. Two main periods of smelting activities during the last 2200 years were revealed bythe lead concentration and isotopic composition along the core profile: the first period corresponds to the Gallic period (approximately ca. 300 B.C. to ca. 20 A.D.) and the second one to the Medieval period (approximately ca. 1000-1300 A.D.). Forest disturbances are associated with lead anomalies for the two metallurgical activities described. The impact of the first metallurgy was moderate during the Gallic period, during which beech and birch were the tree species most affected. The second period corresponds to the observed slag present in the field. Along with agropastoral activities, the medieval smelting activities led to the definitive disappearance of all tree species on the summit zones of Mont Lozère. The abundance of ore resources and the earlier presence of wood on the massif justify the presence of workshops at this place. The relationship between mines and ores has been documented for the Medieval period. There is no archaeological proof concerning the Gallic activity. Nevertheless, 2500-2100 years ago, the borders of the Gallic Tribe territory, named the Gabales, were the same as the present-day borders of the Lozère department. Julius Caesar reported the existence of this tribe in 58 B.C. in "De Bello Gallico", and in Strabon (Book IV, 2.2) the "Gabales silver" and a "treasure of Gabales" are mentioned, but to this day, they have not been found.

Das „Mini-ICF-Rating für psychische Störungen (Mini-ICF-P)”. Ein Kurzinstrument zur Beurteilung von Fähigkeitsstörungen bei psychischen Erkrankungen

Supplementary to the description of diseases at symptom level, the International Classification of Functioning, Disability and Health (ICF), edited by the WHO, for the first time enables a systematic description also at the level of disabilities and impairments. The Mini-ICF-Rating for Mental Disorders (Mini-ICF-P) is a short observer rating instrument for the assessment of disabilities, especially with regard to occupational functioning. The Mini-ICF-P was first evaluated empirically in 125 patients of a Department of Behavioural Medicine and Psychosomatics. Parallel-test reliability was r = 0.59. Correlates were found with cognitive and motivational variables and duration of sick leave from work. In summary, the Mini-ICF-P is a quick and practicable instrument.

The seroepidemiology of Bordetella pertussis infection in Western Europe

High titres of pertussis toxin (PT) antibody have been shown to be predictive of recent infection with Bordetella pertussis. The seroprevalence of standardized anti-PT antibody was determined in six Western European countries between 1994 and 1998 and related to historical surveillance and vaccine programme data. Standardized anti-PT titres were calculated for a series of whole-cell and acellular pertussis vaccine trials. For the serological surveys, high-titre sera (> 125 units/ml) were distributed throughout all age groups in both high- (> 90%) and low-coverage (< 90%) countries. High-titre sera were more likely in infants in countries using high-titre-producing vaccines in their primary programme (Italy, 11.5%; Western Germany, 13.3%; France, 4.3%; Eastern Germany, 4.0%) compared to other countries (The Netherlands, 0.5%; Finland, 0%). Recent infection was significantly more likely in adolescents (10-19 years old) and adults in high-coverage countries (Finland, The Netherlands, France, East Germany), whereas infection was more likely in children (3-9 years old) than adolescents in low-coverage (< 90%; Italy, West Germany, United Kingdom) countries. The impact and role of programmatic changes introduced after these surveys aimed at protecting infants from severe disease by accelerating the primary schedule or vaccinating older children and adolescents with booster doses can be evaluated with this approach.