Dynamics of SARS-CoV-2 immunity after vaccination and breakthrough infection in rituximab-treated rheumatoid arthritis patients: a prospective cohort study

Background

SARS-CoV-2 vaccination in rheumatoid arthritis (RA) patients treated with B cell-depleting drugs induced limited seroconversion but robust cellular response. We aimed to document specific T and B cell immunity in response to vaccine booster doses and breakthrough infection (BTI).

Methods

We included 76 RA patients treated with rituximab who received up to four SARS-CoV-2 vaccine doses or three doses plus BTI, in addition to vaccinated healthy donors (HD) and control patients treated with tumor necrosis factor inhibitor (TNFi). We quantified anti-SARS-CoV-2 receptor-binding domain (RBD) Spike IgG, anti-nucleocapsid (NC) IgG, 92 circulating inflammatory proteins, Spike-binding B cells, and Spike-specific T cells along with comprehensive high-dimensional phenotyping and functional assays.

Findings

The time since the last rituximab infusion, persistent inflammation, and age were associated with the anti-SARS-CoV-2 RBD IgG seroconversion. The vaccine-elicited serological response was accompanied by an incomplete induction of peripheral Spike-specific memory B cells but occurred independently of T cell responses. Vaccine- and BTI-elicited cellular immunity was similar between RA and HD ex vivo in terms of frequency or phenotype of Spike-specific cytotoxic T cells and in vitro in terms of the functionality and differentiation profile of Spike-specific T cells.

Interpretation

SARS-CoV-2 vaccination in RA can induce persistent effector T-cell responses that are reactivated by BTI. Paused rituximab medication allowed serological responses after a booster dose (D4), especially in RA with lower inflammation, enabling efficient humoral and cellular immunity after BTI, and contributed overall to the development of potential durable immunity.

Birth asphyxia and its implications for neuropsychology and brain volume in schizophrenia

Introduction

Newborn infants can suffer permanent brain damage as a result of birth asphyxia (ASP), a severe obstetric complication (OC). However, effects of OCs on cognitive abilities and brain structure in schizophrenia (SZ) are unknown.

Objectives

The main goals of this study were to investigate putative effects of a history of OCs on adult cognition and brain structure in SZ.

Methods

We utilized prospective data from the Medical Birth Registry of Norway to identify incidences of severe OCs in adult healthy controls (HC; n = 622) and patients with SZ (n = 607). IQ was assessed, and a subset of participants (n= 414) underwent magnetic resonance imaging.

Results

Severe OCs (27%) and ASP (14%) were equally common in SZ and HC. SZ patients with OCs had lower IQ than patients without OCs, a difference not found in HC (p = .023). Having experienced more than one co-occurring severe OC was associated with lower IQ in both groups, wherein 81% of co-occurring OCs involved ASP. ASP was related to smaller intracranial volume and brain volumes in both groups. Smaller caudate volumes were found in SZ patients with ASP compared to patients without ASP, a difference not found in HC (p = .009).

Conclusions

Our findings give support for an effect of birth ASP on brain development in both patients with SZ and HC. OC history specifically impacts IQ in SZ. Smaller caudate volumes might be particularly related to disease development. These results warrant replication in an independent sample.

Disclosure

No significant relationships.

Determination of Fumonisins B1 and B2 in Corn and Corn Flakes by Liquid Chromatography with Immunoaffinity Column Cleanup: Collaborative Study

A liquid chromatographic (LC) method for the determination of fumonisins B1 (FB1) and B2 (FB2) in corn and corn flakes was collaboratively studied by 23 laboratories, which analyzed 5 blind duplicate pairs of each matrix to establish the accuracy, repeatability, and reproducibility characteristics of the method. Fumonisin levels in the corn ranged from <0.05 (blank) to 1.41 μg/g for FB1 and from <0.05 to 0.56 μg/g for FB2, whereas in the corn flakes they ranged from <0.05 to 1.05 μg/g for FB1 and from <0.05 to 0.46 μg/g for FB2. The method involved double extraction with acetonitrile–methanol–water (25 + 25 + 50), cleanup through an immunoaffinity column, and LC determination of the fumonisins after derivatization with o-phthaldialdehyde. Relative standard deviations for the within-laboratory repeatability (RSDr) of the corn analyses ranged from 19 to 24% for FB1 and from 19 to 27% for FB2; for the corn flakes analyses, RSDr ranged from 9 to 21% for FB1 and from 8 to 22% for FB2. Relative standard deviations for the between-laboratories reproducibility (RSDR) of the corn analyses ranged from 22 to 28% for FB1 and from 22 to 30% for the FB2; for corn flakes analyses, RSDR ranged from 27 to 32% for FB1 and from 26 to 35% for FB2. Mean recoveries of FB1 and FB2 from corn spiked with FB1 at 0.80 μg/g and with FB2 at 0.40 μg/g were 76 and 72%, respectively; for corn flakes spiked at the same levels recoveries were 110 and 97% for FB1 and FB2, respectively. HORRAT ratios for the analyses of corn ranged from 1.44 to 1.53 for FB1 and from 0.96 to 1.48 for FB2, whereas for corn flakes they ranged from 1.60 to 1.82 for FB1 and from 1.39 to 1.68 for FB2.

Combined Phenyl Silane and Immunoaffinity Column Cleanup with Liquid Chromatography for Determination of Ochratoxin A in Roasted Coffee: Collaborative Study

A collaborative study was conducted to evaluate a liquid chromatography (LC) method for ochratoxin A using sequential phenyl silane and immunoaffinity column cleanup. The method was tested at 3 different levels of ochratoxin A in roasted coffee, which spanned the range of possible future European regulatory limits. The test portion was extracted with methanol and sodium bicarbonate by shaking for 30 min. The extract was filtered, centrifuged, and then cleaned up on a phenyl silane column before being eluted from the washed column with methanol–water. The eluate was diluted with phosphate-buffered saline (PBS) and applied to an ochratoxin A immunoaffinity column, which was washed with water. The ochratoxin A was eluted with methanol, the solvent was evaporated, and the residue was redissolved in injection solvent. After injection of this solution onto a reversed-phase LC apparatus, ochratoxin A was measured by fluorescence detection. Eight laboratory samples of low-level naturally contaminated roasted coffee and 2 laboratory samples of blank coffee (< 0.2 ng/g ochratoxin A at the signal-to-noise ratio of 3:1), along with ampules of ochratoxin A calibrant and spiking solutions, were sent to 15 laboratories in 13 different European countries. Test portions of the laboratory samples were spiked at levels of 4 ng/g ochratoxin A, and recoveries ranged from 65 to 97%. Based on results for spiked blank material (blind duplicates) and naturally contaminated material (blind duplicates at 3 levels), the relative standard deviation for repeatability (RSDr) ranged from 2 to 22% and the relative standard deviation for reproducibility (RSDR) ranged from 14 to 26%. The method showed acceptable within- and between-laboratory precision, as evidenced by HORRAT values, at the low level of determination for ochratoxin A in roasted coffee.

Receptor mediated binding of avidin to polymer covered liposomes

Fluoresence technique involving a receptor-mediated fluorescence increase of bodipy-labeled avidin upon binding to biotinylated lipids has been used to investigate the steric barrier effect of submicellar concentrations of poly(ethylene glycol)-phospholipids (PE-PEG(2000) and PE-PEG(5000)) incorporated into pure DPPC liposomes as well as PE-PEG(5000) incorporated into DPPC liposomes containing 20 mol% cholesterol. It is found that the incorporation of PE-PEG lipopolymers into DPPC lipid bilayers lowers the receptor-mediated adhesion of avidin to the biotinylated liposomes. The most pronounced screening effect is observed at surface densities corresponding to the mushroom conformation of the polymer. Furthermore, the results show that the steric baric effect induced by the surface-grafted polymers becomes stronger when the length of the polymer chain increases. In addition it is found that cholesterol improves the barrier effect of PE-PEG(5000) at low lipopolymer concentrations while no effect is observed at higher concentrations. The results reveal that both the surface density and the polymer length of the PE-PEG lipopolymers play a major role for the accessibility of avidin to biotin surface receptors. However, none of the lipopolymers were capable of completely preventing avidin from reaching the surface bound ligands. Cholesterol only affected the barrier effect at lipopolymer concentrations below the mushroom to brush transition. Consequently, from a steric stabilization viewpoint there is no rationale for incorporating cholesterol into liposomes when the PE-PEG lipopolymer concentration exceeds the mushroom to brush transition. The results presented in this study are of importance in relation to a deeper understanding of the interaction of liposome degrading enzymes and proteins with polymer covered liposomes as well as for the receptor-based targeting and interaction of liposomes with cell surface receptors.

Methods for chemical analysis of contaminated soil samples--tests of their reproducibility between Nordic laboratories

In an effort to develop common analytical methods for contaminated soil samples the Environmental Authorities of the Nordic countries have, together with Nordtest, published the report Nordic Guidelines for Chemical Analysis of Contaminated Soil Samples. The aim of these guidelines has been to describe analytical methods which could be accepted in all the Nordic countries and in that way contribute to reducing the variation in the analytical results between laboratories. The methods covered, reflects environmental concerns and priorities in the Nordic countries for now, i.e. heavy metals, chlorophenols, creosote, volatile organic compounds, PCB, THC and PAH. The repeatability and reproducibility of the guideline methods were determined in a Nordic inter-laboratory test in 1996, and the results showed some variations. The analytical methods and the results from the inter-laboratory tests are given for heavy metals, chlorophenols, creosote, volatile organic compounds and PCB.

Distribution of diarrhetic shellfish poisoning toxins in consignments of blue mussel

Data describing the distribution of diarrhetic shellfish poisoning toxins in 13 consignments of Danish-produced blue mussels are reported. The content of diarrhetic shellfish poisoning toxins was measured by a liquid chromatography coupled with tandem mass spectrometry detection method, and mean levels in the 13 consignments varied from 58 to 243 microg kg(-1). The distributions of diarrhetic shellfish poisoning toxins in the consignments were relatively homogeneous as the relative standard deviation of the content varied from 7 to 19%. The results are discussed in relation to food safety, the uncertainty of sampling and analysis, and the newly introduced European Union maximum levels of marine biotoxins in seafood products.

Diarrhetic shellfish poisoning toxin esters in Danish blue mussels and surf clams

Until recently, little focus was given to the presence of diarrhetic shellfish poisoning (DSP) toxin esters in seafood products. However, during the last few years, the occurrence of a high percentage of esters of the total amount of DSP toxins present in some seafood products has been observed. Samples of Danish surf clams (Spisola spp.) and blue mussels (Mytilus edulis) from 1999-2004 were analysed by liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS) for the presence of DSP toxin esters. The samples contained only okadaic acid and esters of okadaic acid. The level of total okadaic acid equivalents ranged from 224 to 2516 microg kg-1 in surf clams. The percentage of okadaic acid esters of the total okadaic acid equivalents ranged from 83 to 98%, mean 95%. The level of total okadaic acid equivalents ranged from 43 to 1631 microg kg-1 in blue mussels. The percentage of okadaic acid esters of the total okadaic acid equivalents ranged from 21 to 86%, mean 59%. The probability of a high percentage of okadaic acid esters seems to increase with higher amounts of total okadaic acid equivalents in the bivalves. The large prevalence of DSP toxin esters are of particular importance because of the increased use of chemical methods instead of mouse bioassay for the detection of DSP toxicity.

Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients—a pilot study

This study investigated the effects of heavy resistance training in elderly males with chronic obstructive pulmonary disease (COPD). 18 Home-dwelling male patients (age range: 65-80 years), with a mean forced expiratory volume in the first second (FEV1) of 46 +/- 3.4% of predicted value, were recruited. Baseline and post-training assessments included: Cross-sectional area (CSA) of quadriceps assessed by MRI, isometric and isokinetic knee extension strength, isometric trunk strength, leg extension power, normal and maximal gait-speed on a 30 m track, stair climbing time, number of chair stands in 30 s, lung function (FEV1) and self-reported health. Subjects were randomized to a resistance training group (RE, n = 9) or a control group conducting breathing exercises (CON, n = 9). RE performed heavy progressive resistance training twice a week for 12 weeks. 6 RE and 7 CON completed the study. In RE the following improved (P < 0.05): Quadriceps CSA: 4%, isometric knee extension strength: 14%, isokinetic knee extension strength at 60 degrees /s.: 18%, leg extension power: 19%, maximal gait speed: 14%, stair climbing time: 17%, isometric trunk flexion: 5% and self-reported health. In CON no changes were found. In conclusion, 12 weeks of heavy resistance training twice a week resulted in significant improvements in muscle size, knee extension strength, leg extension power, functional performance and self-reported health in elderly male COPD patients.

Chicken juice, a food-based model system suitable to study survival of Campylobacter jejuni

AIMS

The purpose of this study was to develop a food-based model system that resembles the environment that Campylobacter jejuni experiences on raw poultry products and use this model system to investigate growth and survival of the bacterium.

METHODS AND RESULTS

Chicken juice was collected from frozen chickens and subsequently cleared by centrifugation and subjected to sterile filtration. At low temperatures (5 and 10 degrees C) C. jejuni NCTC11168 remained viable in chicken juice for a remarkably longer period of time than in the reference medium BHI. When exposed to heat stress (48 degrees C) C. jejuni NCTC11168 also showed increased viability in chicken juice compared with the reference medium. Furthermore, agar plates made with chicken juice supported growth of four clinical isolates of C. jejuni and a C. jejuni strain obtained from chicken at both 37 and 42 degrees C.

CONCLUSIONS

Our work shows that minimal processed and sterilized chicken juice is an ideal environment for survival of C. jejuni and that it is useful as a food-based model system.

SIGNIFICANCE AND IMPACT OF THE STUDY

The developed model system may contribute to the understanding of C. jejuni viability on poultry products and can be instrumental in the development of alternative preservation strategies.

Occurrence of ochratoxin A in Danish wheat and rye, 1992-99

Ochratoxin A concentrations in rye and wheat in Denmark for 1992-99 are reported. The results show that the concentration of ochratoxin A is higher in rye than in wheat for both conventionally and organically grown rye and wheat. The levels in organically grown rye are higher than in conventionally grown based on multiyear mean contents. However, the difference between the two groups of cereals has decreased since the Danish food-monitoring system for ochratoxin A was started in 1986; 2.0% of all samples exceeded the Danish maximum limit of 5 micro g kg(-1) introduced in 1995. For rye samples, 3.2% exceeded the maximum limit, and for wheat samples, 0.5% exceeded the maximum limit.

Nondestructive measurement of light-induced oxidation in dairy products by fluorescence spectroscopy and imaging

The purpose of this paper is to demonstrate the potential of solid-sample fluorescence spectroscopy in nondestructive assessment of light-induced oxidation in different dairy products such as Swiss cheese, cream cheese, and sour cream. Analytical and quantitative spectral properties of fluorescence were elucidated by use of principal component analysis with designed experiments involving different levels of air and light exposure. A significant reduction in fluorescence intensity at approximately 525 nm, and a corresponding increase in the region 415 to 490 nm as a result of illumination was observed on all the products. The effect was ascribed to photodegradation of riboflavin. Variation in two smaller peaks at approximately 620 nm and 630 nm was an interaction effect between exposure to light and air. A pronounced interaction effect between light and air produced intense blue fluorescence and off-flavors on Swiss-like Jarlsberg cheese. High correlations (0.83 to 0.93) between fluorescence spectra and sensory measured off-flavors were obtained for cream cheese. Results indicate that solid-sample fluorescence can be used as a nondestructive and rapid tool to measure the degree of light-induced degradation of riboflavin as well as sensory properties connected to storage of dairy products. Images of fluorescence can be used to visualize the intensity and propagation of this process. The simplicity and rapidity of the method offer rich opportunities for efficient evaluation of factors affecting light-induced oxidation in dairy products, such as packaging materials, light sources, exposure time, and temperature.

Anaerobic power and muscle strength characteristics of 11 years old elite and non-elite boys and girls from gymnastics, team handball, tennis and swimming

The aim of the present investigation was to study the possible effects of specificity of training on muscle strength and anaerobic power in children from different sports and at different performance levels in relation to growth and maturation status. Hundred and eighty-four children of both gender participating either in swimming, tennis, team handball or gymnastics were recruited from the best clubs in Denmark. Within each sport, the coach had divided the children into an elite (E) and non-elite (NE) group according to performance level and talent. Tanner stage assessment and body weight and height measurements were performed by a physician. The anaerobic performances were assessed by Wingate tests and jumping performance in squat jump (SJ), countermovement jump (CMJ) and drop jump (DJ) from two heights. Most of the differences between groups in Wingate performance disappeared when the data were normalised to body mass. The gymnasts were the best jumpers and their superiority were increased in the more complex motor coordination tasks like DJ. The results may indicate some influence of training specificity, especially on the more complex motor tasks as DJ and there may be an effect of training before puberty. The performance in the less complex motor tasks like cycling and SJ and CMJ may also be influenced by specific training, but not to the same extent, and heritance may be an important factor for performance in these anaerobic tasks.

Content of ochratoxin A in paired kidney and meat samples from healthy Danish slaughter pigs

In 1999, paired samples of kidney and meat were taken from 300 healthy Danish pigs and analysed for ochratoxin A. The concentrations of ochratoxin A in kidney ranged from 0 to 15 microg kg(-1) (mean 0.50 microg kg(-1), median 0.18 microg kg(-1)) and in meat from 0 to 2.9 microg kg(-1) (mean 0.12 microg kg(-1), median 0.03 microg kg(-1)). The data together with the Danish control data show that today the pig industry in Denmark has no problem keeping the content of ochratoxin A in pig at very low levels even in years with wet harvest conditions. The mean ratio 'content in meat/content in kidney' for paired samples was 39%. For kidney samples >1.0 microg kg(-1), the mean ratio was 22%. The Danish control system for ochratoxin A in pig kidney established in 1978 can be regarded as a success because the levels in pig have been reduced substantially, and hence for the consumer the contribution from pig products to the total intake of ochratoxin A is very small compared with other sources.

Structural, physicochemical, and pasting properties of starches from potato plants with repressed r1-gene

The aim of this work was to investigate the effect on starch molecular and physicochemical properties of down regulation of the R1 protein in potato (Solanum tuberosum L. cv. "Dianella") tubers. Most prominent is a 90% suppression of the phosphate content in the isolated potato tuber starch. The amylopectin chain length distribution profile as determined by HPAEC/PAD was not affected, but the amylose content was increased in the most down-regulated plants. The pasting properties of the transgenic starch revealed a pronounced decrease in peak viscosity and increased setback viscosity as measured using a rapid Visco analyzer. The starch gels displayed an increased hardness and stickiness with a maximum at 1.7 nmol of Glc-6P mg-1 of starch compared to the control lines. At very low phosphate levels (1.4 nmol of Glc-6P mg-1 of starch), the gel hardness was decreased as a result of increased gel brittleness. The increase in gel brittleness is believed to be an effect of an increased proportion of free amylopectin blocklets in the starch as determined by SEC/RI. The possible links between the structural and physicochemical parameters are discussed.

Dynamical and structural properties of lipid membranes in relation to liposomal drug delivery systems

The structural and dynamical properties of DPPC liposomes containing lipopolymers (PEG-lipids) and charged DPPS lipids have been studied in relation to the lipid membrane interaction of enzymes and peptides. The results suggest that both the lipid membrane structure and dynamics and in particular the appearance of small-scale lipid structures might be of importance for the activity of membrane associated and liposome degrading enzymes as well as for the membrane interaction of acylated peptides. The combined experimental and simulation results are of relevance for a rational development of peptide loaded liposomal drug delivery systems that become destabilized by membrane degrading phospholipase A(2) enzymes, which are found at elevated concentrations at diseased sites.

Phospholipase A(2) activity towards vesicles of DPPC and DMPC-DSPC containing small amounts of SMPC

Phospholipase A(2) (PLA(2)) is an interfacially active enzyme whose hydrolytic activity is known to be enhanced in one-component phospholipid bilayer substrates exhibiting dynamic micro-heterogeneity. In this study the activity of PLA(2) towards large unilamellar vesicles composed of DPPC:SMPC and DMPC:DSPC:SMPC is investigated using fluorescence and HPLC techniques. Phase diagrams of the mixtures are established by differential scanning calorimetry and the PLA(2) activity, monitored by the lag time, is correlated with the phase behavior of the mixtures. In addition, the degree of lipid hydrolysis in the DMPC:DSPC:SMPC lipid mixtures is detected by HPLC. The PLA(2) activity is found to be significantly increased in the temperature range of the coexistence region where the lipid mixtures exhibit lateral gel-fluid phase separation. Furthermore, in the entire temperature range it is demonstrated that PLA(2) preferentially hydrolyzes the short chain DMPC lipid. This discriminative effect becomes less pronounced when the asymmetric lipid SMPC is present in the lipid substrate. Inclusion of SMPC into either DPPC or DMPC:DSPC vesicles prolongs the lag time. The results clearly show that the PLA(2) activity is significantly enhanced by lipid bilayer micro-heterogeneity in both one-component and multi-component lipid bilayer substrates. The PLA(2) activity measurements are discussed in terms of dynamic gel-fluid lipid domain formation due to density fluctuations and static lipid domain formation due to gel-fluid phase separation.

Association of acylated cationic decapeptides with dipalmitoylphosphatidylserine-dipalmitoylphosphatidylcholine lipid membranes

The interaction of three acylated and cationic decapeptides with lipid membranes composed of dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylserine (DPPS) has been studied by means of fluorescence spectroscopy and differential scanning calorimetry (DSC). The synthetic model decapeptides that are N-terminally linked with C(2), C(8), and C(14) acyl chains contain four basic histidine residues in their identical amino acid sequence. A binding model, based on changes in the intrinsic fluorescent properties of the peptides upon association with the DPPC-DPPS membranes, is used to estimate the peptide-membrane dissociation constants. The results clearly show that all three peptides have a higher affinity to liposomes containing DPPS lipids due to non-specific electrostatic interactions between the cationic peptides and the anionic DPPS lipids. Furthermore, it is found that the acyl chain length of the peptides plays a crucial role for the binding. A preference for fluid phase membranes as compared to gel phase membranes is generally observed for all three peptides. DSC is used to characterise the influence of the three peptides on the thermodynamic phase behaviour of the binary DPPC-DPPS lipid mixture. The extent of peptide association deduced from the heat capacity measurements suggests a strong binding and membrane insertion of the C(14) acylated peptide in accordance with the fluorescence measurements.

Lateral organization and domain formation in a two-component lipid membrane system

The thermodynamic phase behavior and lateral lipid membrane organization of unilamellar vesicles made from mixtures of 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2 distearoyl-sn-glycero-3-phosphocholine (DSPC) were investigated by fluorescence resonance energy transfer (FRET) as a function of temperature and composition. This was done by incorporating a headgroup-labeled lipid donor (NBD-DPPE) and acceptor (N-Rh-DPPE) in low concentrations into the binary mixtures. Two instances of increased energy transfer efficiency were observed close to the phase lines in the DMPC/DSPC phase diagram. The increase in energy transfer efficiency was attributed to a differential preference of the probes for dynamic and fluctuating gel/fluid coexisting phases. This differential preference causes the probes to segregate (S. Pedersen, K. Jørgensen, T. R. Baekmark, and O. G. Mouritsen, 1996, Biophys. J. 71:554-560). The observed increases in energy transfer match with the boundaries of the DMPC/DSPC phase diagram, as measured by Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). We propose that the two instances of probe segregation are due to the presence of DMPC-rich and DSPC-rich domains, which form a dynamic structure of gel/fluid coexisting phases at two different temperatures. Monitoring the melting profile of each lipid component independently by FTIR shows that the domain structure is formed by DMPC-rich and DSPC-rich domains rather than by pure DMPC and DSPC domains.

Quantitative ultrasound image analysis of the supraspinatus muscle

OBJECTIVE

To develop and validate a method, based on quantitative ultrasound image analysis, to objectively analyse and characterize the ultrasound images of m. supraspinatus.

DESIGN

Quantitative ultrasonography was performed on the supraspinatus muscle of 14 healthy subjects.

METHODS

A computerized analysis using first-order grey-scale statistics to evaluate the muscle tissue composition was developed and validated.

RESULTS

Data from one scanning site were not representative for the whole muscle due to muscle inhomogenity. Using first-order grey-scale statistics the scanning direction was of no importance. By using a scanning session consisting of three different scanning sites along the muscle in two directions, longitudinally and transversely, to characterize the tissue composition of the muscle, a high day-to-day reproducibility was obtained.

CONCLUSION

The described scanning session is a relatively sensitive and reproducible method for studying the muscle tissue composition. RelevanceQuantitative ultrasonography seems to be a potential clinical and occupational examination method to detect tissue composition of myalgic muscles compared to healthy muscles.

Screening effect of PEG on avidin binding to liposome surface receptors

This study investigates the screening effect of poly(ethylene glycol)-phospholipids (PE-PEG) on the interaction of avidin with PEGylated liposomes containing surface-bound biotin ligands. The influence of grafting density and lipopolymer chain length is examined. A simple fluorescence assay involving a receptor-mediated fluorescence increase of BODIPY-labeled avidin upon binding to biotinylated lipids is employed to study the screening effect of submicellar concentrations of 1,2-dipalmitoyl-sn-glycero-3-phosphatidylethanolamine-N-[poly(ethylene glycol)-2000] (PE-PEG(2000)) and 1,2-dipalmitoyl-sn-glycero-3-phosphatidylethanolamine-N-[poly(ethylene glycol)-5000] (PE-PEG(5000)) incorporated into 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC) liposomes. The results show that incorporation of lipopolymers into DPPC lipid bilayers reduces binding of avidin to the biotinylated liposomes, and it is found that the screening effect of PE-PEG(5000) is stronger than that for PE-PEG(2000). Thus, the results reveal that both the grafting density and the polymer length of the PE-PEG lipopolymers are of importance for the ability of water-soluble macromolecules to reach the surface of PEG liposomes. Furthermore, it is found that none of the lipopolymers completely prevents avidin from reaching the surface-bound biotin ligands.

Activity of mammalian secreted phospholipase A(2) from inflammatory peritoneal fluid towards PEG-liposomes. Early indications

Due to an increase in the activity of phospholipase A(2) (PLA(2)) in various inflammatory diseases, this enzyme may play a key role in the degradation of liposomes and the subsequent release of drug when PEG-liposomes passively target inflammatory tissue. The activity of mammalian secreted phospholipase A(2) (sPLA(2)) in casein stimulated peritoneal fluid was tested toward liposomes of different compositions. Early results indicate only a slight degradation of conventional dipalmitoylphosphatidylcholine (DPPC) liposomes as well as DPPC liposomes incorporated with different concentrations of PEG(2000). However, the DPPC degradation increased to 7% when inclusion of 30 mol% phosphatidylethanolamine (PE) in the lipid bilayer. The increase in degradation may be due to an improvement of the substrate - as it is well known, that PE is a better substrate for the mammalian sPLA(2) than PC. Incorporation of PE into the bilayer may increase the binding properties of the bilayer resulting in improved conditions for the enzymatic attack by sPLA(2). In addition, inhibitory zones of Staphylococcus aureus in an agar diffusion test showed that PLA(2) from Crotalus atrox venom was able to catalyze the release of gentamicin from PEG-liposomes. In conclusion, this study suggest that degradation of the lipid bilayer of PEG-liposomes by PLA(2) result in release of incapsulated drug, e.g. gentamicin and inclusion of PE in the liposomal bilayer, may enhance the activity of the mammalian sPLA(2) toward liposomes composed of DPPC.

Drug delivery by phospholipase A(2) degradable liposomes

The effect of poly(ethylene glycol)-phospholipid (PE-PEG) lipopolymers on phospholipase A(2) (PLA(2)) hydrolysis of liposomes composed of stearoyl-oleoylphosphatidylcholine (SOPC) was investigated. The PLA(2) lag-time, which is inversely related to the enzymatic activity, was determined by fluorescence, and the zeta-potentials of the liposomes were measured as a function of PE-PEG lipopolymer concentration. A significant decrease in the lag-time, and hence an increase in enzymatic activity, was observed with increasing amounts of the negatively charged PE-PEG lipopolymers incorporated into the SOPC liposomes. The enhancement of the PLA(2) enzymatic activity might involve a stronger PLA(2) binding affinity towards the negatively charged and polymer covered PEG liposomes.

Association of an acylated model peptide with DPPC-DPPS lipid membranes

The interaction between a small positively charged peptide with a N-terminally linked acyl chain and dipalmitoylphosphatidylcholine-dipalmitoylphosphatidylserine (DPPC-DPPS) lipid membranes has been studied by means of fluorescence resonance energy transfer. Two different lipid compositions were used: a neutral membrane (100 mol% DPPC), and a negatively charged membrane (30 mol% DPPS in DPPC). The fluorescence resonance energy transfer results reveal that the peptide associates with both types of membranes. Furthermore, it is found that the slope of the titration curve for the negatively charged membranes is much steeper than that for the neutral membranes. This indicates a higher binding affinity of the acylated peptide towards negatively charged lipid membranes as compared with neutral lipid membranes.

Enzymatic degradation of polymer covered SOPC-liposomes in relation to drug delivery

Polyethylenoxide (PEG) covered liposomes are used as lipid-based drug-delivery systems. In comparison to conventional liposomes the polymer-covered liposomes display a long circulation half-life in the blood stream. We investigate the influence of polyethyleneoxide-distearoylphosphatidylethanolamine (DSPE-PEG750) lipopolymer concentration on phospholipase A2 (PLA2) catalyzed hydrolysis of liposomes composed of stearoyloleoylphosphatidylcholine (SOPC). The characteristic PLA2 lag-time was determined by fluorescence and the degree of lipid hydrolysis was followed by HPLC analysis. Particle size and zeta-potential were measured as a function of DSPE-PEG750 lipopolymer concentration. A significant decrease in the lag-time, and hence an increase in enzyme activity, was observed with increasing concentrations of the anionic DSPE-PEG750 lipopolymer lipids. The observed decrease in lag-time might be related to changes in the surface potential and the PLA2 lipid membrane affinity.

The diagnostic efficiency of the Rorschach Depression Index and the Schizophrenia Index: a review

This review focuses on the diagnostic efficiency of the new versions of the Rorschach Comprehensive System Depression Index (DEPI) and the Schizophrenia Index (SCZI). Clinical diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders was chosen as the external validation criteria. The sensitivity, specificity, and overall classification rates for the indices were presented from the studies or computed from the data when possible. The positive and negative predictive validity was estimated at three different base rates. As regards the DEPI the results showed a large variation in diagnostic performance as the index seemed to have relatively more success in identifying nonpsychotic and unipolar depression than psychotic and bipolar depression. The DEPI did not successfully identify depression among adolescent patients. As regards the SCZI the results more consistently indicated that the index effectively discriminates between psychotic and nonpsychotic patients and the predictive validity of both a positive and negative SCZI was found to be high.

Physiological response to submaximal isometric contractions of the paravertebral muscles

STUDY DESIGN

Brief (30-second) isometric trunk extensions at 5%, 20%, 40%, 60%, and 80% of maximal voluntary contraction (MVC) and 3 minutes of prolonged trunk extension (20% MVC) in erect position were studied in nine healthy male subjects.

OBJECTIVES

To investigate the intercorrelation between intramuscular pressure and tissue oxygenation of the paravertebral muscles during submaximal isometric contractions and further, to evaluate paravertebral electromyogram and intramuscular pressure as indicators of force development.

SUMMARY OF BACKGROUND DATA

Local physiologic responses to muscle contraction are incompletely understood.

METHODS

Relative oxygenation was monitored with noninvasive near-infrared spectroscopy, intramuscular pressure was measured with a transducer-tipped catheter, and surface electromyogram was monitored at three recording sites.

RESULTS

The root mean square amplitudes of the paravertebral electromyogram (L4, left and right; T12, right) and intramuscular pressure measured in the lumbar multifidus muscle at L4 increased with greater force development in a curvilinear manner. A significant decrease in the oxygenation of the lumbar paravertebral muscle in response to muscle contraction was found at an initial contraction level of 20% MVC. This corresponded to a paravertebral intramuscular pressure of 30-40 mm Hg. However, during prolonged trunk extension, no further decrease in tissue oxygenation was found compared with the tissue oxygenation level at the end of the brief contractions, indicating that homeostatic adjustments (mean blood pressure and heart rate) over time were sufficient to maintain paravertebral muscle oxygen levels.

CONCLUSION

At a threshold intramuscular pressure of 30-40 mm Hg during muscle contraction, oxygenation in the paravertebral muscles is significantly reduced. The effect of further increase in intramuscular pressure on tissue oxygenation over time may be compensated for by an increase in blood pressure and heart rate. Surface electromyogram amplitudes and intramuscular pressure can be used as indicators of paravertebral muscle force.

Analysis of ochratoxin A in pig kidney and rye flour using liquid chromatography tandem mass spectrometry (LC/MS/MS)

A liquid chromatography electrospray tandem mass spectrometric (LC/MS/MS) method is described for analysis and confirmation of ochratoxin A in pig kidney and rye flour using derivatization of ochratoxin A to the methyl ester. Ochratoxin A methyl(d3)ester is used as internal standard. The method works well, the detection limit is 0.02 microgram/kg and the repeatability (coefficient of variation) is between 6% and 16% in the contamination range 0.5 to 8 micrograms/kg.

Association of ethanol with lipid membranes containing cholesterol, sphingomyelin and ganglioside: a titration calorimetry study

The association of ethanol at physiologically relevant concentrations with lipid bilayers of different lipid composition has been investigated by use of isothermal titration calorimetry (ITC). The liposomes examined were composed of combinations of lipids commonly found in neural cell membranes: dimyristoyl phosphatidylcholine (DMPC), ganglioside (GM(1)), sphingomyelin and cholesterol. The calorimetric results show that the interaction of ethanol with fluid lipid bilayers is endothermic and strongly dependent on the lipid composition of the liposomes. The data have been used to estimate partitioning coefficients for ethanol into the fluid lipid bilayer phase and the results are discussed in terms of the thermodynamics of partitioning. The presence of 10 mol% sphingomyelin or ganglioside in DMPC liposomes enhances the partitioning coefficient by a factor of 3. Correspondingly, cholesterol (30 mol%) reduces the partitioning coefficient by a factor of 3. This connection between lipid composition and partitioning coefficient correlates with in vivo observations. Comparison of the data with the molecular structure of the lipid molecules suggests that ethanol partitioning is highly sensitive to changes in the lipid backbone (glycerol or ceramide) while it appears much less sensitive to the nature of the head group.

Interaction of a lipid-membrane destabilizing enzyme with PEG-liposomes

Polymer grafted PEG-liposomes have come into use as drug-delivery systems with improved therapeutic profiles. However, very little is known about the morphological instability of PEG-liposomes due to enzymatic degradation. To gain further insight into the effect of PEG lipopolymer-concentration on the catalytic activity of a liposome-degrading enzyme, phospholipase A2 (PLA2)-catalyzed phospholipid hydrolysis of PEG-liposomes has been investigated. The temperature dependence of the PLA2 lag-time, denoting the time required before a sudden increase in enzymatic activity takes place, has been determined for submicellar amounts of dipalmitoylphosphatidylethanolaminyl-poly-(ethylene glycol) (DPPE-PEG2000) incorporated into unilamellar dipalmitoylphosphatidylcholine (DPPC)-liposomes. The measurements demonstrate a significant reduction in the lag-time over broad temperature ranges. The results suggest that a close relationship exists between PLA2 catalyzed lipid hydrolysis and lipid-membrane composition, which moreover is of major importance for the overall morphological stability and the release of encapsulated material from the polymer-grafted PEG-liposomes.

Influence of lipopolymer concentration on liposome degradation and blood clearance

It is well known, that a prolonged liposome circulation time can be achieved by incorporation of lipopolymers into the lipid membrane thereby reducing interactions with destabilizing factors in the blood stream, e.g. phagocytic cells and lipoproteins. However, very little is known about the enzymatic degradation of steric hindered liposomes introduced into body fluids. In this study, the blood clearance and the PLA2 catalyzed degradation of unilamellar dipalmitoylphosphatidylcholine (DPPC) liposomes incorporated with increasing amounts of dipalmitoylphosphatidylethanolamine-polyethyleneglycol (DPPE-PEG), was investigated. The results demonstrated an increase in PLA2 activity for increasing amounts of lipopolymer in the lipid membrane, while the liposome blood clearance was prolonged by incorporation of DPPE-PEG into the liposomes. Hence, these results suggest that it may be possible for long circulating liposomes to obtain a site specific liposome degradation and release of drug substance in tissue with high levels of PLA2.

Fatigue in patients with Parkinson's disease

OBJECTIVE

To compare the prevalence of fatigue in patients with Parkinson's disease (PD) with that in healthy elderly people and to explore the suggestion that fatigue is an independent symptom of PD.

DESIGN

Questionnaire survey.

SETTING

Community-based population.

PATIENTS AND CONTROL SUBJECTS

233 patients derived from a prevalence study in the county of Rogaland, Norway and 100 healthy elderly people with the same age and sex distribution as the patients with PD.

MAIN OUTCOME MEASURE

A score for fatigue was obtained by combining the results from the rating scale for low energy in the Nottingham Health Profile (NHP) with the results obtained from a 7-point scale devised to evaluate fatigue.

RESULTS

44.2% of the patients with PD and 18% of the healthy elderly control subjects reported fatigue. Fatigue was associated with depression, dementia, disease severity, disease duration, levodopa dose, and the use of sleeping pills. In a multivariate analysis, only depressive symptoms reached statistical significance. The prevalence of fatigue in patients with PD who were not depressed, demented, or had a sleeping disturbance was similar to that found in the total PD population.

CONCLUSION

Fatigue is a common symptom in PD. Although fatigue correlated with depressive symptoms, patients with PD who did not have depression, dementia, or sleep disturbances also reported a high prevalence of this symptom. This supports the hypothesis that fatigue is an independent symptom of PD overlapping with, but not causally related to, the concurrence of depressive symptoms.

The muscular load on the lower back and shoulders due to lifting at different lifting heights and frequencies

The aim of the study was to investigate the muscular load on the lower back and shoulders and the circulatory load on employees at a post center during repetitive lifting of mail transport boxes. A mock-up was designed in the laboratory, a total of nine combinations of lifting height and frequency were studied. Surface EMG was recorded bisymmetrically from m. erector spinae (L3-level) and m. trapezius. The circulatory load was evaluated by measuring the heart rate. The results show a trade off between the low back and shoulders. The maximum load on the low back occurred at the low lifting height (363 and 54.4 cm) whereas the maximum load on the shoulders occurred at the high lifting height (144.9 and 163.0 cm).

A new look at lipid-membrane structure in relation to drug research

Lipid-bilayer membranes are key objects in drug research in relation to (i) interaction of drugs with membrane-bound receptors, (ii) drug targeting, penetration, and permeation of cell membranes, and (iii) use of liposomes in micro-encapsulation technologies for drug delivery. Rational design of new drugs and drug-delivery systems therefore requires insight into the physical properties of lipid-bilayer membranes. This mini-review provides a perspective on the current view of lipid-bilayer structure and dynamics based on information obtained from a variety of recent experimental and theoretical studies. Special attention is paid to trans-bilayer structure, lateral molecular organization of the lipid bilayer, lipid-mediated protein assembly, and lipid-bilayer permeability. It is argued that lipids play a major role in lipid membrane-organization and functionality.

Increase in phospholipase A2 activity towards lipopolymer-containing liposomes

Phospholipase A2 (PLA2)-catalyzed hydrolysis of dipalmitoylphosphatidylcholine (DPPC) liposomes incorporated with submicellar concentrations of polyethyleneoxide covalently attached to dipalmitoylphosphatidylethanolamine (DPPE-PEG2000) has been studied in the gel-to-fluid transition region of the host DPPC lipid bilayer matrix. By means of fluorescence and light-scattering measurements, the characteristic PLA2 lag time has been determined as a function of lipopolymer concentration and temperature. The degree of lipid hydrolysis was followed using radioactive labeled lipids. Differential scanning calorimetry has been applied to characterize the thermodynamic phase behavior of the lipopolymer-containing liposomes. A remarkable lipopolymer concentration-dependent decrease in the lag time was observed over broad temperature ranges. The radioactive measurements demonstrate an increase in catalytic activity for increasing amounts of lipopolymers in the bilayer. Hence, the lipopolymers act as a promoter of PLA2 lipid hydrolysis resulting in a degradation of the bilayer structure and a concomitant destabilization of the liposomes. This behavior is in contrast to the generally observed protective and stabilization effect in biological fluids exerted by lipopolymers in polymer-grafted liposomes. It is proposed that the enhanced activity of the small water soluble and interfacially active enzyme may involve a non-uniform distribution of the lipopolymers in the lipid matrix due to a coupling between local lipid bilayer curvature and composition of the non-bilayer-preferring lipopolymers.

Survey of pork, poultry, coffee, beer and pulses for ochratoxin A

Surveys have been carried out to estimate the levels of ochratoxin A in pork, poultry, coffee, beer and pulses. A total of 286 samples were analysed. The results show that compared with cereals and cereal products the contribution from the foods surveyed to the total intake of ochratoxin A by the Danish population must be considered to be of less importance.

Effect of traditional Chinese acupuncture on severe tinnitus: a double-blind, placebo-controlled, clinical investigation with open therapeutic control

This study aims to determine the effect of intensive acupuncture on severe tinnitus. The structure of the study was a randomized, double-blind, clinical investigation with open therapeutic surveillance and included 54 patients. All were subjected to 25 treatment sessions over a period of two months, each treatment lasting 30 minutes. Fifty-two patients completed the study. The variables used for self-registration were based on the visual analogue scale (VAS), where annoyance, loudness and awareness of the tinnitus were assessed. These were recorded twice daily over a four-month period starting one month before the first treatment and ending one month after the last treatment. Questionnaires, interviews and audiometry were carried out repeatedly. No statistically significant differences were found between the acupuncture group and the placebo group.

A randomized double-blind phase III study of nimorazole as a hypoxic radiosensitizer of primary radiotherapy in supraglottic larynx and pharynx carcinoma. Results of the Danish Head and Neck Cancer Study (DAHANCA) Protocol 5-85

PURPOSE

A multicenter randomized and balanced double-blind trial with the objective of assessing the efficacy and tolerance of nimorazole given as a hypoxic radiosensitizer in conjunction with primary radiotherapy of invasive carcinoma of the supraglottic larynx and pharynx.

PATIENTS AND TREATMENT

Between January 1986 and September 1990, 422 patients (414 eligible) with pharynx and supraglottic larynx carcinoma were double-blind randomized to receive the hypoxic cell radiosensitizer nimorazole, or placebo, in association with conventional primary radiotherapy (62-68 Gy, 2 Gy per fraction, five fractions per week). The median observation time was 112 months.

RESULTS

Univariate analysis showed that the outcome (5-year actuarial loco-regional tumor control) was significantly related to T-classification (T1-T2 48% versus T3-T4 36%, P = 0.0008), neck-nodes (N- 53% versus N+ 33%), pre-irradiation hemoglobin (Hb) concentration (high 46% versus low 37%, P = 0.02) and sex (females 51% versus males 38%, P = 0.03). Overall the nimorazole group showed a significantly better loco-regional control rate than the placebo group (49 versus 33%, P = 0.002). A similar significant benefit of nimorazole was observed for the end-points of final loco-regional control (including surgical salvage) and cancer-related deaths (52 versus 41%, P = 0.002). This trend was also found in the overall survival but to a lesser, non-significant extent (26 versus 16%, 10-year actuarial values, P = 0.32). Cox multivariate regression analysis showed the most important prognostic parameters for loco-regional control to be positive neck nodes (relative risk 1.84 (1.38-2.45)), T3-T4 tumor (relative risk 1.65 (1.25-2.17)) and nimorazole (relative risk 0.69 (0.52-0.90)). The same parameters were also significantly related to the probability of dying from cancer. The compliance to radiotherapy was good and 98% of the patients received the planned dose. Late radiation-related morbidity was observed in 10% of the patients, irrespective of nimorazole treatment. Drug-related side-effects were minor and tolerable with transient nausea and vomiting being the most frequent complications.

CONCLUSION

Nimorazole significantly improves the effect of radiotherapeutic management of supraglottic and pharynx tumors and can be given without major side-effects.

Lack of predictive value of potential doubling time and iododeoxyuridine labelling index in radiotherapy of squamous cell carcinoma of the head and neck

PURPOSE

To investigate the prognostic value of T(POT), S-phase time (TS), iododeoxyuridine (IdUrd) labelling index (LI) and DNA index with loco-regional tumour control as the end-point.

MATERIALS AND METHODS

Iododeoxyuridine was given to 99 patients with squamous cell carcinomas of the head and neck before the start of radiotherapy. The analysis included FCM parameters (LI, TS, T[POT] and DNA index, n = 87) and LI determined by immunohistology (IHC, n = 45). A hybrid T(POT) was determined by combining the FCM TS and the IHC LI (n = 45). In diploid tumours (n = 39), the FCM LI was underestimated and the FCM T(POT) was overestimated because the flow cytometer was unable to distinguish between tumour and normal cells. The 'tumour LI' was defined as the IHC LI or the FCM LI of aneuploid tumours when a biopsy for IHC evaluation was not available and similarly the 'tumour T(POT)' was determined by the hybrid T(POT) or the FCM T(POT) of aneuploid tumours (n = 63).

RESULTS

There was good agreement between the IHC LI and the FCM LI for aneuploid tumours, but there was disagreement for diploid tumours. The median tumour T(POT) was 4.1 days (range 0.6-19.5 days) and the median tumour LI was 12.9% (range 3.1-46.0%). In a univariate analysis there was no prediction of loco-regional tumour control by the LI, the TS or the T(POT) determined by either of the methods. T-classification, N-classification, clinical stage and tumour diameter were related with loco-regional tumour control, whereas clinical stage was the only parameter that yielded independent prognostic significance in a multivariate analysis.

CONCLUSIONS

This study does not confirm the significant prognostic value of T(POT) as indicated in some previous reports. Larger clinical studies are needed to draw final conclusions.

Significance of mat and shoe softness during prolonged work in upright position: based on measurements of low back muscle EMG, foot volume changes, discomfort and ground force reactions

The aim of the investigation was to study the significance of mat and shoe softness during prolonged work in an upright position based on some physiological, biomechanical and comfort measurements related to the lower extremities and the low back. Eight healthy female volunteers performed 2 h of simulated standing and 2 h of standing/walking work tasks in the laboratory using four combinations of soft shoes, clogs, soft mat and concrete. Thus, each subject performed a total of eight 2 h work tests. The following parameters were measured pre-experimentally and one or more times during 2 h: total foot volume, vascular volume and interstitial volume of the left foot, EMG from the lumbar paraspinals, movement of centre of gravity (only during standing), biomechanical heel impact (only during standing/walking), perceived discomfort in lumbar back, legs and feet, whole body oxygen uptake, arterial blood pressure and heart rate. Using soft shoes rather than clogs during standing/walking work implies approximately a halving of the foot oedema formation and the heel impact. The effects due to the introduction of the soft mat are negligible. The local circulatory responses in the feet and the EMG-signs of paravertebral muscle fatigue are larger during standing compared to standing/walking work. The two investigated work types in this study differ regarding exposures as well as responses. Thus, it is recommended to shift between these postures and seated work during the working hours to improve job exposures.