Fractionated vs single-dose gemtuzumab ozogamicin with determinants of benefit in older patients with AML: the UK NCRI AML18 trial

Addition of gemtuzumab ozogamicin (GO) to induction chemotherapy improves outcomes in older patients with acute myeloid leukemia (AML), but it is uncertain whether a fractionated schedule provides additional benefit to a single dose. We randomized 852 older adults (median age, 68-years) with AML/high-risk myelodysplasia to GO on day 1 (GO1) or on days 1 and 4 (GO2) of course 1 induction. The median follow-up period was 50.2 months. Although complete remission (CR) rates after course 1 did not significantly differ between arms (GO2, 63%; GO1, 57%; odds ratio [OR], 0.78; P = .08), there were significantly more patients who achieved CR with a measurable residual disease (MRD)<0.1% (50% vs 41%; OR, 0.72; P = .027). This differential MRD reduction with GO2 varied across molecular subtypes, being greatest for IDH mutations. The 5-year overall survival (OS) was 29% for patients in the GO2 arm and 24% for those in the GO1 arm (hazard ratio [HR], 0.89; P = .14). In a sensitivity analysis excluding patients found to have adverse cytogenetics or TP53 mutations, the 5-year OS was 33% for GO2 and 26% for GO1 (HR, 0.83; P = .045). In total, 228 (27%) patients received an allogeneic transplantation in first remission. Posttransplant OS was superior in the GO2 arm (HR, 0.67; P = .033); furthermore, the survival advantage from GO2 in the sensitivity analysis was lost when data of patients were censored at transplantation. In conclusion, GO2 was associated with a greater reduction in MRD and improved survival in older adults with nonadverse risk genetics. This benefit from GO2 was dependent on allogeneic transplantation to translate the better leukemia clearance into improved survival. This trial was registered at www.isrctn.com as #ISRCTN 31682779.

GTAC enables parallel genotyping of multiple genomic loci with chromatin accessibility profiling in single cells

Understanding clonal evolution and cancer development requires experimental approaches for characterizing the consequences of somatic mutations on gene regulation. However, no methods currently exist that efficiently link high-content chromatin accessibility with high-confidence genotyping in single cells. To address this, we developed Genotyping with the Assay for Transposase-Accessible Chromatin (GTAC), enabling accurate mutation detection at multiple amplified loci, coupled with robust chromatin accessibility readout. We applied GTAC to primary acute myeloid leukemia, obtaining high-quality chromatin accessibility profiles and clonal identities for multiple mutations in 88% of cells. We traced chromatin variation throughout clonal evolution, showing the restriction of different clones to distinct differentiation stages. Furthermore, we identified switches in transcription factor motif accessibility associated with a specific combination of driver mutations, which biased transformed progenitors toward a leukemia stem cell-like chromatin state. GTAC is a powerful tool to study clonal heterogeneity across a wide spectrum of pre-malignant and neoplastic conditions.

Phase Ib study of eltrombopag and azacitidine in patients with high-risk myelodysplastic syndromes and related disorders (the ELASTIC study)

Treating adverse risk myelodysplastic syndromes with azacitidine exacerbates thrombocytopenia. We report a study of eltrombopag in combination with azacitidine using a 3 + 3 cohort design. Patients with baseline platelets of <150 × 109 /l received eltrombopag ranging from 25 to 300 mg. An 8-day pre-phase of eltrombopag was followed by two cycles of combined therapy. Amongst 31 patients, there were no dose-limiting toxicities. The maximum tolerated dose (MTD) was 300 mg. Transient increases in bone marrow blasts at day 8 were common but no patient had protocol-defined progression following eltrombopag monotherapy. Marrow response rates after three and six treatment cycles were 32% and 29% respectively. In all, 70% of patients treated below and 36% treated at the MTD achieved a modified International Working Group 2006 platelet response at the end of cycle two. Of the platelet transfusion independent patients at baseline, 67% treated at the MTD became transfusion dependent during the first two cycles of treatment. Apart from lack of disease progression, our findings concur with a previously reported Phase III study (A StUdy of eltromboPag in myelodysPlastic SyndrOmes Receiving azaciTidine [SUPPORT]). We conclude that eltrombopag/azacitidine is safe in terms of conventional measures defined by adverse-event reporting. However, in light of SUPPORT and our own descriptive findings regarding efficacy, further combination studies in high-risk disease should be considered with caution.

Heterogeneous genetic and non-genetic mechanisms contribute to response and resistance to azacitidine monotherapy

Acute myeloid leukaemia is prevalent in older patients that are often ineligible for intensive chemotherapy and treatment options remain limited with azacitidine being at the forefront. Azacitidine has been used in the clinic for decades, however, we still lack a complete understanding of the mechanisms by which the drug exerts its anti-tumour effect. To gain insight into the mechanism of action, we defined the mutational profile of sequential samples of patients treated with azacitidine. We did not identify any mutations that could predict response and observed lack of a uniform pattern of clonal evolution. Focusing on responders, at remission, we observed three types of response: (1) an almost complete elimination of mutations (33%), (2) no change (17%), and (3) change with no discernible pattern (50%). Heterogeneous patterns were also observed at relapse, with no clonal evolution between remission and relapse in some patients. Lack of clonal evolution suggests that non-genetic mechanisms might be involved. Towards understanding such mechanisms, we investigated the immune microenvironment in a number of patients and we observed lack of a uniform response following therapy. We identified a higher frequency of cytotoxic T cells in responders and higher frequency of naïve helper T cells in non-responders.

Experimental helium-beam radiography with a high-energy beam: Water-equivalent thickness calibration and first image-quality results

PURPOSE

A clinical implementation of ion-beam radiography (iRad) is envisaged to provide a method for on-couch verification of ion-beam treatment plans. The aim of this work is to introduce and evaluate a method for quantitative water-equivalent thickness (WET) measurements for a specific helium-ion imaging system for WETs that are relevant for imaging thicker body parts in the future.

METHODS

Helium-beam radiographs (αRads) are measured at the Heidelberg Ion-beam Therapy Center (HIT) with an initial beam energy of 239.5 MeV/ u. An imaging system based on three pairs of thin silicon pixel detectors is used for ion path reconstruction and measuring the energy deposition (dE) of each particle behind the object to be imaged. The dE behind homogeneous plastic blocks is related to their well-known WETs between 280.6mm and 312.6 mm with a calibration curve that is created by fitting the measured data points. The quality of the quantitative WET measurements is determined by the uncertainty of the measured WET of a single ion (single-ion WET precision) and the deviation of a measured WET value to the well-known WET (WET accuracy). Subsequently, the fitted calibration curve is applied to an energy deposition radiograph of a phantom with a complex geometry. The spatial resolution (modulation transfer function at 10% (MTF_10% )) and WET accuracy (mean absolute percentage difference (MAPD)) of the WET map, are determined.

RESULTS

In the optimal imaging WET-range from ∼  280 mm to 300 mm, the fitted calibration curve reached a mean single-ion WET precision of 1.55 ± 0.00%. Applying the calibration to an ion radiograph (iRad) of a more complex WET distribution, the spatial resolution was determined to be MTF_10% = 0.49 ± 0.03 lp/mm and the WET accuracy was assessed as MAPD to 0.21%.

CONCLUSIONS

Using a beam energy of 239.5MeV/ u and the proposed calibration procedure, quantitative αRads of WETs between ∼  280mm to 300 mm can be measured and show high potential for clinical use. The proposed approach with the resulting image qualities encourages further investigation towards the clinical application of helium-beam radiography. This article is protected by copyright. All rights reserved.

Combination romidepsin and azacitidine therapy is well tolerated and clinically active in adults with high-risk acute myeloid leukaemia ineligible for intensive chemotherapy

Azacitidine (AZA) is important in the management of patients with acute myeloid leukaemia (AML) who are ineligible for intensive chemotherapy. Romidepsin (ROM) is a histone deacetylase inhibitor which synergises with AZA in vitro. The ROMAZA trial established the maximum tolerated dose (MTD) of combined ROM/AZA therapy in patients with AML, as ROM 12 mg/m2 on Days 8 and 15, with AZA 75 mg/m2 administered for 7/28 day cycle. Nine of the 38 (23·7%) patients treated at the MTD were classified as responders by Cycle 6 (best response: complete remission [CR]/incomplete CR n = 7, partial response n = 2). Correlative next-generation sequencing studies demonstrated important insights into therapy resistance.

Prevalence of disorders in preweaned dairy calves from 731 dairies in Germany: A cross-sectional study

The objective of this cross-sectional study was to determine the prevalence of disorders in preweaned calves in 3 regions in Germany, exemplary for structural diversity in dairy farming. A farm visit was performed on a single occasion on 731 dairy farms in the northern, eastern, and southern regions of Germany between December 2016 and July 2019. Farms differed in herd size, geographical location, and management. In the northern region, the farms had a median of 90 milking cows and were often run as full-time family businesses, partly with external workers. The eastern region tended to have larger farms (a median of 251 milking cows), which were often large-scale agricultural enterprises with employees. In the southern region, the farms had a median of 39 milking cows and were often traditional family businesses, some of these being part-time businesses. Clinical examinations were performed on 14,164 preweaned dairy calves (median 12 calves per farm) by trained veterinarians. A complete data set was available for 13,656 calves. Almost half (42.0%) of the evaluated calves were classified as being affected by at least 1 of the common calf disorders. Omphalitis (O, 20.9%; n = 2,876) and diarrhea (D, 18.5%; n = 2,670) were the most frequently recorded diagnoses, whereas respiratory diseases (RD) were observed to a lesser extent (8.7%; n = 1,100). A striking feature was the fact that 7.1% (n = 987) of the calves were affected by more than 1 disorder at the same time (multimorbidity, M). The following combinations of disorders were frequently observed: O and D (n = 596), O and RD (n = 164), and D and RD (n = 140). Disorders such as O and D, as well as M, were predominantly observed in calves aged 2 wk. A gradual increase in the frequency of RD was observed with age. For all disorders except RD, male calves were more often affected than females. Omphalitis was predominantly diagnosed in the summer months, whereas RD, D, and M were more common in the fall. We detected several statistically significant differences in the prevalence of clinical signs and disorders in preweaned dairy calves between the 3 exemplary regions. The prevalence of RD was higher in the south (10.8%) than in the north (8.2%) and east (7.4%). In the north (33.2%), O was observed more frequently than in the other regions (east: 18.9%; south: 10.5%), whereas D was found less frequently in the north (13.8%) than in the east (21.6%) and south (20.0%).

Applicability and reproducibility of acute myeloid leukaemia stem cell assessment in a multi-centre setting

Leukaemic stem cells (LSC) have been experimentally defined as the leukaemia‐propagating population and are thought to be the cellular reservoir of relapse in acute myeloid leukaemia (AML). Therefore, LSC measurements are warranted to facilitate accurate risk stratification. Previously, we published the composition of a one‐tube flow cytometric assay, characterised by the presence of 13 important membrane markers for LSC detection. Here we present the validation experiments of the assay in several large AML research centres, both in Europe and the United States. Variability within instruments and sample processing showed high correlations between different instruments (R_pearson > 0·91, P < 0·001). Multi‐centre testing introduced variation in reported LSC percentages but was found to be below the clinical relevant threshold. Clear gating protocols resulted in all laboratories being able to perform LSC assessment of the validation set. Participating centres were nearly unanimously able to distinguish LSC^high (>0·03% LSC) from LSC^low (<0·03% LSC) despite inter‐laboratory variation in reported LSC percentages. This study proves that the LSC assay is highly reproducible. These results together with the high prognostic impact of LSC load at diagnosis in AML patients render the one‐tube LSC assessment a good marker for future risk classification.

Short communication: Design and validation of a hygiene score for calves

The objective of this study was the establishment and validation of a scoring system for calf dirtiness. Defined areas of the belly, side, and rear of the calves were scored according to the percentage of dirtiness: score 1 ranges from 0 to 10% of the area (no or little soiling), score 2 from over 10 to 30% (medium soiling), and score 3 applies to soiling of more than 30% of the area (heavy soiling). The scores of the individual regions were summed up to yield the calf hygiene score (CHS) ranging from 3 to 9. The validation of the CHS was performed by 5 veterinarians on 42 calves. It was validated for its inter- and intra-observer-reliability and against a standard method created by image processing of photographs of calves. The agreement between the observers and the standard method was weak to moderate with kappa values from 0.58 to 0.67. Inter- and intra-observer reliability resulted in a moderate to strong agreement with 29 of 36 kappa values between 0.60 and 0.89. The CHS was thus successfully validated as reliable and could be a useful tool for herd health management.

Mechanisms of Progression of Myeloid Preleukemia to Transformed Myeloid Leukemia in Children with Down Syndrome

Myeloid leukemia in Down syndrome (ML-DS) clonally evolves from transient abnormal myelopoiesis (TAM), a preleukemic condition in DS newborns. To define mechanisms of leukemic transformation, we combined exome and targeted resequencing of 111 TAM and 141 ML-DS samples with functional analyses. TAM requires trisomy 21 and truncating mutations in GATA1; additional TAM variants are usually not pathogenic. By contrast, in ML-DS, clonal and subclonal variants are functionally required. We identified a recurrent and oncogenic hotspot gain-of-function mutation in myeloid cytokine receptor CSF2RB. By a multiplex CRISPR/Cas9 screen in an in vivo murine TAM model, we tested loss-of-function of 22 recurrently mutated ML-DS genes. Loss of 18 different genes produced leukemias that phenotypically, genetically, and transcriptionally mirrored ML-DS.

A Recurrent Activating Missense Mutation in Waldenström Macroglobulinemia Affects the DNA Binding of the ETS Transcription Factor SPI1 and Enhances Proliferation

The ETS-domain transcription factors divide into subfamilies based on protein similarities, DNA-binding sequences, and interaction with cofactors. They are regulated by extracellular clues and contribute to cellular processes, including proliferation and transformation. ETS genes are targeted through genomic rearrangements in oncogenesis. The PU.1/SPI1 gene is inactivated by point mutations in human myeloid malignancies. We identified a recurrent somatic mutation (Q226E) in PU.1/SPI1 in Waldenström macroglobulinemia, a B-cell lymphoproliferative disorder. It affects the DNA-binding affinity of the protein and allows the mutant protein to more frequently bind and activate promoter regions with respect to wild-type protein. Mutant SPI1 binding at promoters activates gene sets typically promoted by other ETS factors, resulting in enhanced proliferation and decreased terminal B-cell differentiation in model cell lines and primary samples. In summary, we describe oncogenic subversion of transcription factor function through subtle alteration of DNA binding leading to cellular proliferation and differentiation arrest. SIGNIFICANCE: The demonstration that a somatic point mutation tips the balance of genome-binding pattern provides a mechanistic paradigm for how missense mutations in transcription factor genes may be oncogenic in human tumors.This article is highlighted in the In This Issue feature, p. 681.

Technical note: Automatic evaluation of infrared thermal images by computerized active shape modeling of bovine udders challenged with Escherichia coli

Mastitis causes substantial economic losses and animal suffering in the dairy industry. The trend toward larger herd sizes complicates the monitoring of udder health in individual animals. Infrared thermography has successfully been used for early mastitis detection. However, manual thermogram analysis is time consuming and requires a skilled examiner, and automated image processing has not been tested. The aim of this study was to determine whether automatic evaluation of thermograms showed results comparable to those of manual evaluation of thermograms. Five healthy cows underwent an intramammary challenge with Escherichia coli to induce clinical mastitis. Multiple udder thermograms were taken every 2 h for 24 h before and after the challenge, resulting in 4,143 images in total. All images were evaluated using image recognition software (automatically) and a polygon tool (manually) to calculate the average and maximum surface temperatures. Because of the slightly different regions of interest, temperatures ascertained from the thermograms using the automatic method were consistently lower than those ascertained using the manual method. However, average udder surface temperatures evaluated using both methods were strongly correlated (r = 0.98 in the left hindquarter, and r = 0.99 in the right hindquarter) and showed maximum temperature peaks at the same time, 13 and 15 h after intramammary challenge. In the receiver operating characteristic analysis, both methods provided good results for sensitivity and specificity in detecting clinical E. coli-induced mastitis at different threshold values. For automatically evaluated maximum right hindquarter temperature, sensitivity was 93.75% and specificity was 94.96%, and for manually evaluated maximum right hindquarter temperature, sensitivity was 93.75% and specificity was 96.40%. Thus, automatic thermogram evaluation is a promising tool for automated mastitis detection.

Clonal heterogeneity of acute myeloid leukemia treated with the IDH2 inhibitor enasidenib

Mutations in the gene encoding isocitrate dehydrogenase 2 (IDH2) occur in several types of cancer, including acute myeloid leukemia (AML). In model systems, mutant IDH2 causes hematopoietic differentiation arrest. Enasidenib, a selective small-molecule inhibitor of mutant IDH2, produces a clinical response in 40% of treated patients with relapsed/refractory AML by promoting leukemic cell differentiation. Here, we studied the clonal basis of response and acquired resistance to enasidenib treatment. Using sequential patient samples, we determined the clonal structure of hematopoietic cell populations at different stages of differentiation. Before therapy, IDH2-mutant clones showed variable differentiation arrest. Enasidenib treatment promoted hematopoietic differentiation from either terminal or ancestral mutant clones; less frequently, treatment promoted differentiation of nonmutant cells. Analysis of paired diagnosis/relapse samples did not identify second-site mutations in IDH2 at relapse. Instead, relapse arose by clonal evolution or selection of terminal or ancestral clones, thus highlighting multiple bypass pathways that could potentially be targeted to restore differentiation arrest. These results show how mapping of clonal structure in cell populations at different stages of differentiation can reveal the response and evolution of clones during treatment response and relapse.

Jodmangel als Bestandsproblem in einem ökologisch geführten Milchviehbetrieb

Gegenstand: Abklärung von Umfangsvermehrungen in der Kehlgangsregion, Entwicklungsstörungen und Atemwegserkrankungen bei Kälbern in einem bayerischen Biobetrieb. Methoden: Drei Kälber wurden an die Klinik für Wiederkäuer der LMU München zur Abklärung des Bestandsproblems überwiesen. In der Folge fand ein Betriebsbesuch statt und ein Kalb wurde zur Behandlung in der Klinik aufgestallt. Ergebnisse: Alle Kälber im Betrieb im Alter zwischen einem Tag und 6 Monaten waren abgemagert und im Wachstum zurückgeblieben. Acht Kälber zeigten im Larynxbereich eine palpierbare Umfangsvermehrung. Bei neun Kälbern sowie fünf laktierenden Kühen wurden Blutproben auf Glutathion-Peroxidase-Aktivität (GSH-Px), Thyroxin- (T4) und Selenkonzentration (Se) untersucht. Die drei zuvor an die Klinik überwiesenen Patienten zeigten vergleichbare Symptome. Bei der Sektion fanden sich Umfangsvermehrungen im Kehlgangsbereich mit einem Durchmesser von 7–15 cm. Ferner bestand eine hochgradige Broncho pneumonie und in einem Fall eine fibrinöse Pleuritis. Der histologische Befund der Umfangsvermehrungen lautete Hypertrophie und Hyperplasie mit Hyperämie der Schilddrüse (Struma). Die T4-Serumkonzentration war bei drei von neun Tieren sehr niedrig (< 0,5 μg/l) und die GSH-Px-Aktivität lag bei allen Tieren unter 42 U/g Hb. Eine Futtermittelanalyse des ad libitum gefütterten Heus ergab eine Jodkonzentration von 0,32 mg/kg Trockensubstanz. Das angebotene Mineralfutter enthielt kein Selen oder Jod. Das in der Klinik aufgestallte eintägige Kalb mit Struma, Selenmangel und Bronchopneumonie wurde mit Kaliumjodid, Selen, Vitamin E und einem Antibiotikum behandelt, erholte sich und wurde geheilt entlassen. Schlussfolgerung und klinische Relevanz: Anhand der Befunde wurde ein Jod- und Selenmangel verbunden mit gehäuft auftretenden Broncho - pneumonien als Bestandsproblem diagnostiziert. Für Jod und Selen gibt es in den Richtlinien für ökologisch geführte Betriebe keine Restriktionen. Es wird empfohlen, in Betrieben in Jod- und Selenmangelgebieten ein besonderes Augenmerk auf die Mineralstoff- und Spurenelementversorgung zu legen. Dies gilt besonders für ökologisch geführte Betriebe, wenn diese nur betriebseigene Futtermittel einsetzen.

Validierung anamnestischer Angaben und ausgewählter klinischer Befunde im Hinblick auf Endokarditis beim Rind

Gegenstand und Ziel: Ziel dieser retrospektiven Arbeit war die Prüfung der diagnostischen Validität verschiedener anamnestischer Angaben und klinischer Befunde im Hinblick auf Endokarditis (EK). Material und Methoden: Zur Auswertung gelangten 958 Klinikkarten der Patienten der Klinik für Wiederkäuer aus den Jahren 1997–2004. Die Tiere wurden aufgrund ihres Herzbefundes, der sich aus der klinischen Untersuchung ergab (Herzgeräusch oder kein Herzgeräusch) und aufgrund des Sektionsbefundes (EK oder keine EK) in vier Gruppen eingeteilt. Ergebnisse: Zwischen den an EK erkrankten und nicht erkrankten Tieren bestanden signifikante Unterschiede hinsichtlich Ernährungszustand, Verhalten, Jugularvenen- und Herzbefunden. Außerdem litten EK-Patienten häufiger an Gliedmaßenproblemen. Schlussfolgerung und klinische Relevanz: Aus dem Vorbericht, den Ergebnissen der klinischen Untersuchung sowie den hämatologischen und klinisch-chemischen Befunden lässt sich der Verdacht auf eine Endokarditis zwar erhärten, aber die Sicherung der Diagnose ist nach wie vor in vielen Fällen der pathologischen Untersuchung vorbehalten.

Outcome of Azacitidine Therapy in Acute Myeloid Leukemia Is not Improved by Concurrent Vorinostat Therapy but Is Predicted by a Diagnostic Molecular Signature

Purpose: Azacitidine (AZA) is a novel therapeutic option in older patients with acute myeloid leukemia (AML), but its rational utilization is compromised by the fact that neither the determinants of clinical response nor its mechanism of action are defined. Co-administration of histone deacetylase inhibitors, such as vorinostat (VOR), is reported to improve the clinical activity of AZA, but this has not been prospectively studied in patients with AML.Experimental Design: We compared outcomes in 259 adults with AML (n = 217) and MDS (n = 42) randomized to receive either AZA monotherapy (75 mg/m2 × 7 days every 28 days) or AZA combined with VOR 300 mg twice a day on days 3 to 9 orally. Next-generation sequencing was performed in 250 patients on 41 genes commonly mutated in AML. Serial immunophenotyping of progenitor cells was performed in 47 patients.Results: Co-administration of VOR did not increase the overall response rate (P = 0.84) or overall survival (OS; P = 0.32). Specifically, no benefit was identified in either de novo or relapsed AML. Mutations in the genes CDKN2A (P = 0.0001), IDH1 (P = 0.004), and TP53 (P = 0.003) were associated with reduced OS. Lymphoid multipotential progenitor populations were greatly expanded at diagnosis and although reduced in size in responding patients remained detectable throughout treatment.Conclusions: This study demonstrates no benefit of concurrent administration of VOR with AZA but identifies a mutational signature predictive of outcome after AZA-based therapy. The correlation between heterozygous loss of function CDKN2A mutations and decreased OS implicates induction of cell-cycle arrest as a mechanism by which AZA exerts its clinical activity. Clin Cancer Res; 23(21); 6430-40. ©2017 AACR.

Fatal proteinuric kidney disease in a 30-month-old German Fleckvieh heifer caused by unilateral focal segmental glomerulosclerosis subsequent to a non-functional counterpart kidney

INTRODUCTION

A case of secondary focal segmental glomerulosclerosis (FSGS) in a heifer is presented. A 30-month-old female German Fleckvieh heifer showed deterioration of the general condition, a poor nutritional status, proteinuria, hypoalbuminemia, and renal azotemia. Pathologically, it was diagnosed with unilateral hydronephrosis, and contralateral renal fibrosis with numerous cysts. Histologically, the fibrotic kidney showed FSGS, hyaline reabsorption droplets in proximal tubular epithelial cells, interstitial fibrosis, and tubulointerstitial inflammation. Apart from that, thrombotic microangiopathy (TMA) was seen in few renal arteries and meningeal arterioles. Pathogenesis of FSGS secondary to unilateral renal parenchymal loss (hydronephrosis) and TMA is discussed.

Hepatic Lipodystrophy in Galloway Calves

Hepatic lipodystrophy in Galloway calves is a fatal liver disease affecting a small proportion of the Galloway breed described in different parts of Europe and North America during the past decades. The clinical findings include a diversity of neurological signs. Clinical pathology findings frequently indicate hepatobiliary disease. Postmortem examination reveals an enlarged, pale yellow, and firm liver. Histologic lesions include hepatic fibrosis, hepatic lipidosis, and bile duct hyperplasia. To date, the etiopathogenesis remains obscure. Infectious causes, intoxications, and a hereditary origin have been considered. We describe hepatic lipodystrophy in Galloway calves from an extensively farmed cow-calf operation in southern Germany. Main clinical findings in 6 calves were consistent with hepatic encephalopathy. Clinical pathology findings in 5 of 6 tested animals revealed increased concentration of total bilirubin (maximum value [MV], 54 μmol/l; reference range [RR], <8.5 μmol/l), direct bilirubin (MV, 20 μmol/l; RR, <3.4 μmol/l), increased activity of gamma glutamyl transferase (MV, 162 U/l; RR, <36 U/l) and glutamate dehydrogenase (MV, 420 U/l; RR, <16 U/l). In addition, activity of glutathione peroxidase was decreased in all tested ( n = 5) animals (MV, 61 U/g hemoglobin [Hb]; RR, >250 U/g Hb). Postmortem examination in 6 calves revealed a firm, diffusely enlarged yellow liver with a finely nodular surface. Histologic lesions included hepatic fibrosis, hepatic lipidosis, and bile duct hyperplasia. Our findings add to the existing data on hepatic lipodystrophy in the Galloway breed and outline a protocol to aid in the diagnosis of this disorder.

Investigations on the possible impact of a glyphosate-containing herbicide on ruminal metabolism and bacteria in vitro by means of the 'Rumen Simulation Technique'

AIMS

This study was performed in a well-established in vitro model to investigate whether the application of a glyphosate-containing herbicide might affect the bacterial communities and some biochemical parameters in a cow's rumen.

METHODS AND RESULTS

The test item was applied in two concentrations (high and low) for 5 days. In a second trial, fermentation vessels were inoculated with Clostridium sporogenes before the high dose was applied. Effluents were analysed by biochemical, microbiological and genetic methods. A marginal increase in short-chain fatty acid production and a reduction in NH3 -N were observed. There were minor and rather equivocal changes in the composition of ruminal bacteria but no indications of a shift towards a more frequent abundance of pathogenic Clostridia species. Clostridium sporogenes counts declined consistently.

CONCLUSIONS

No adverse effects of the herbicide on ruminal metabolism or composition of the bacterial communities could be detected. In particular, there was no evidence of a suspected stimulation of Clostridia growth.

SIGNIFICANCE AND IMPACT OF THE STUDY

Antibiotic activity of glyphosate resulting in microbial imbalances has been postulated. In this exploratory study, however, intraruminal application of concentrations reflecting potential exposure of dairy cows or beef cattle did not exhibit significant effects on bacterial communities in a complex in vitro system. The low number of replicates (n = 3/dose) may leave some uncertainty.

Genetically distinct leukemic stem cells in human CD34- acute myeloid leukemia are arrested at a hemopoietic precursor-like stage

Quek and colleagues identify human leukemic stem cells (LSCs) present in CD34⁻ AML. In-depth characterization of the functional and clonal aspects of CD34⁻ LSCs indicates that most are similar to myeloid precursors.

Our understanding of the perturbation of normal cellular differentiation hierarchies to create tumor-propagating stem cell populations is incomplete. In human acute myeloid leukemia (AML), current models suggest transformation creates leukemic stem cell (LSC) populations arrested at a progenitor-like stage expressing cell surface CD34. We show that in ∼25% of AML, with a distinct genetic mutation pattern where >98% of cells are CD34⁻, there are multiple, nonhierarchically arranged CD34⁺ and CD34⁻ LSC populations. Within CD34⁻ and CD34⁺ LSC–containing populations, LSC frequencies are similar; there are shared clonal structures and near-identical transcriptional signatures. CD34⁻ LSCs have disordered global transcription profiles, but these profiles are enriched for transcriptional signatures of normal CD34⁻ mature granulocyte–macrophage precursors, downstream of progenitors. But unlike mature precursors, LSCs express multiple normal stem cell transcriptional regulators previously implicated in LSC function. This suggests a new refined model of the relationship between LSCs and normal hemopoiesis in which the nature of genetic/epigenetic changes determines the disordered transcriptional program, resulting in LSC differentiation arrest at stages that are most like either progenitor or precursor stages of hemopoiesis.

A controlled trial on the effect of feeding dietary chestnut extract and glycerol monolaurate on liver function in newborn calves

Beginning in the fall of 2010, an increasing and alarming number of cases of calves suffering from liver dystrophy were reported in the south of Germany. An epidemiological investigation was carried out by the authors between November 2010 and July 2011, leading to the implication of a commercial dietary supplement as the potential cause for this outbreak. The components of this product were first tested in a cell culture model and two of them (dietary chestnut extract and glycerol monolaurate) showed a cytotoxic effect. The objective of this study was therefore to evaluate the effect of supplemental feeding of both components alone or in combination on liver function in newborn calves on a commercial dairy farm. Ten calves were enrolled in each of the three treatment groups and the control group (group O) following a blocked design. Treatment consisted of supplementation with chestnut extract at 0.02% of birth body mass (BM) (group C), supplementation with glycerol monolaurate at 0.006% of BM (group G) or a combined treatment (group CG) for five consecutive days. The effect of treatments on liver function was evaluated clinically and by measurement of glutamate dehydrogenase (GLDH) and aspartate aminotransferase (AST) activities as well as the determination of the concentrations of glucose, L‐lactate and total bilirubin in serum. There was a significant increase in GLDH and AST activities and a significant decrease in glucose concentration in treatment groups C and CG compared with the control group (p ≤ 0.035), whereas no difference was shown for group G. Survival was significantly decreased in groups C (p = 0.029) and CG (p = 0.001) compared with both group G and the control group. These results suggest that dietary chestnut extract in an amount of 0.02% of BM alone or in combination has a toxic effect on liver function in newborn calves.

Infection-induced anaemia: a cross-sectional study of 14,636 German travellers aged 20-49 years

BACKGROUND

Anaemia is a frequently diagnosed condition which can develop as a consequence of numerous factors, including infectious diseases (IDs). Travelling, especially in sub-/tropical regions, leads to an elevated risk of contracting IDs. The aim of our study was to assess the epidemiological significance of IDs in inducing anaemia among a large cohort of returned travellers.

METHODS

This was a cross-sectional study in which data on 17,009 returned travellers aged 20-49 years who consulted the travel medicine clinic of the University of Munich between 1999 and 2011 were retrieved and analysed.

RESULTS

Of the returned travellers, 8.3 % (6.0 % of males/10.4 % of females) were diagnosed with anaemia. The prevalence of anaemia was significantly elevated among patients of African (21.4/28.3 %) and Asian (11.6/15.7 %) origin. When the study population was restricted to the 14,636 travellers of German origin, 7.1 % of the returned travellers (4.6/9.6 %) were diagnosed with anaemia. The prevalence was significantly elevated among patients who travelled for >30 days (5.7 of males/10.6 % of females) and for male travellers visiting friends and relatives (7.7 %). However, these correlations were confounded by malaria. The prevalence of anaemia was significantly elevated only among returned travellers diagnosed with malaria (36.1 of males/26.9 % of females) and with symptomatic intestinal Entamoeba histolytica infections (30.0/33.3 %).

CONCLUSION

Following the exclusion of confounding by malaria from the statistical analysis, the prevalence of anaemia was found to be significantly elevated among patients of African and Asian origin, and among patients of German origin who had travelled for >30 days, it could be mainly attributable to chronic, long-lasting causes. Although more than 550 travel-associated IDs were assessed in our study, only symptomatic intestinal Entamoeba histolytica infections and, to an even larger extent, malaria were determined to be of epidemiological significance for inducing anaemia among travellers.

Balling gun-induced trauma in cattle: clinical presentation, diagnosis and prevention

Pharyngeal trauma in cattle can occur during the administration of oral medication using a balling gun. The number of cases of severe complications due to bolus application that have been referred to our hospital has increased from nil between 1996 and 2008 to three or four per year. In our experience, reports by bovine veterinarians of patients with severe and often fatal pharyngeal trauma, which were not referred to the clinic, have become more common in recent years as well. The incidence of this complication is likely to be higher than this number of referrals suggests. Diagnosis without the help of imaging techniques, such as radiography and endoscopy, may be difficult, especially in cases where exploration of the pharynx cannot be carried out, or is unable to confirm the absence or presence of a lesion. Prognosis is often poor in cases where perforation has been confirmed. Boluses are increasingly administered by the owners or farm personnel without the supervision of a veterinarian. In order to prevent losses due to balling gun-induced injuries, the veterinarian plays a crucial role in giving advice to his clients. Five cases of cattle suffering from varying degrees of balling gun-induced trauma are presented, and consideration is given to incorrect application techniques.

Attendance at iron deficiency anaemia clinic: audit of outcomes 5 years on

AIM

To determine the long-term outcomes of patients in whom no initial cause for their anaemia is established.

METHOD

Six hundred and thirty-nine patients presenting to an iron deficiency anaemia pathway were prospectively entered onto a database. Initial assessment included haematological review, coeliac screen, oesophagogastroduodenoscopy and colonic imaging as per British Society of Gastroenterology guidelines. A 5-year audit of outcomes was undertaken using patient medical records and hospital laboratory databases.

RESULTS

A diagnosis was found initially in 266 (42%) patients, with 124 (19%) having a gastrointestinal (GI) luminal neoplasm, 54 (8%) of which were malignant. Twelve patients had a nonluminal or non-GI malignancy. Eighty-eight (14%) had benign upper GI bleeding and 23 (4%) had coeliac disease. One hundred and forty-three (22%) did not have confirmed iron deficiency anaemia on review of haematinics. Complete records were available for 595 (93%) patients at 5 years. Of the 373 patients in whom a cause was not initially diagnosed, 6 (2%) were ultimately diagnosed with a GI luminal malignancy and 18 (5%) with a nonluminal or non-GI malignancy. There was no difference in the incidence of malignancies between those with or without confirmed iron deficiency.

CONCLUSIONS

Most patients in whom no cause was found at initial investigation resolve on oral iron supplements. Patients with normal ferritin values had as high an incidence of GI malignancies as those with low values and should be investigated. In the over 50s if the anaemia remains after a course of iron further investigation is recommended as there is a significant incidence of both GI and non-GI pathology.

[High incidence of jaundice in young calves in Southern Germany]

OBJECTIVE

Between September, 2010, and August, 2011, a series of cases of jaundice of unknown origin in young calves was detected in a number of farms in Southern Germany. This paper describes the syndrome on the basis of 57 cases, and the approach taken to discover the cause.

MATERIAL AND METHODS

The clinical course of the disease is described in 19 patients. Using a case definition (calves aged 1-3 weeks, total serum bilirubin > 20 µmol/l and/or serum glutamate dehydrogenase [GLDH] activity >50U/l and/or autopsy findings with striking liver pathology [jaundice, liver dystrophy, cirrhosis]), 36 farms were included in an epidemiological survey. In a feeding trial, two batches of a dietary supplement feed, previously used in diseased calves on farms, were fed at the dosage recommendations of the manufacturer to four clinically healthy calves over 5days. Four other calves served as controls. The calves were clinically monitored daily, and blood samples were investigated using clinical chemistry and haematology.

RESULTS

Clinical examination revealed behavioural alterations (weakness, tonic-clonic seizures and bawling just before death), recumbency, jaundice and discolouration of faeces. In less severe cases without clinical signs, there was an increase in serum bilirubin concentration and/or GLDH activity. In the epidemiological survey of affected farms, the feeding of a diet supplement feed was registered in 54 of 57 cases. The feeding of two batches of that diet supplement feed to four clinically healthy calves resulted in a significant (p<0.05) increase in bilirubin and lactate concentrations, as well as the GLDH activity in serum, but without serious impairment of the general condition, whereas in control calves, no comparable changes were observed.

CONCLUSION

The results of the epidemiological survey and the feeding trial suggest a causal involvement of a dietary supplement feed. The toxic principle is unknown.

CLINICAL RELEVANCE

Knowledge of the clinical picture and the probable feed-related context is important to detect this disease early. The suspected dietary supplement feed has been taken off the market, but with other products similar problems may arise.

Häufung von Ikterus bei jungen Kälbern in Süddeutschland

Gegenstand: Zwischen September 2010 und August 2011 traten in süddeutschen Rinderbetrieben mehrere Fälle unklarer Hepatopathien bei jungen Kälbern auf. Beschrieben werden die Kasuistik von 57 Fällen und der beschrittene Weg zur Ursachenklärung. Material und Methoden: Der klinische Verlauf der Erkrankung wird anhand von 19 Patienten dargestellt. Eine epidemiologische Erhebung nach Falldefinition (Alter der Tiere 1–3 Wochen, Gesamtbilirubinkonzentration > 20 μmol/l und/oder Glutamatdehydrogenase-[GLDH-]Aktivität > 50 U/l und/oder auffälliger Leberbefund [Ikterus, Leberdystrophie, Leberzirrhose] in der Sektion) umfasste 36 Betriebe. In einem Fütterungsversuch wurden zwei Chargen eines zuvor in betroffenen Betrieben eingesetzten Diätergänzungsfuttermittels nach Herstellerangabe an vier klinisch gesunde Kälber über 5 Tage verfüttert. Vier weitere Kälber dienten als Kontrollen. Täglich erfolgte eine klinische, klinisch-chemische und hämatologische Untersuchung. Ergebnisse: Bei klinisch manifester Erkrankung treten Verhaltensauffälligkeiten (Mattigkeit, tonisch-klonische Krämpfe, Klagen kurz vor dem Verenden), Festliegen, Ikterus und auffällig heller Kot auf. In weniger stark ausgeprägten Fällen ohne klinische Symptomatik bestehen eine erhöhte Serum-Bilirubinkonzentration und/oder GLDH-Aktivität. Die Befragung in betroffenen Betrieben ergab in 54 von 57 Fällen als Gemeinsamkeit den Einsatz eines Diätergänzungsfuttermittels. Im Fütterungsversuch zeigten Versuchskälber eine signifikante (p < 0,05) Erhöhung von Bilirubin- und L-Laktat-Konzentration sowie GLDH-Aktivität im Serum ohne schwerwiegende Beeinträchtigung des Allgemeinbefindens. Bei den Kontrolltieren fehlten vergleichbare Veränderungen. Schlussfolgerung: Epidemiologische Erhebung und Fütterungsversuch deuten auf eine ursächliche Beteiligung eines Diätergänzungsfuttermittels hin. Das toxische Prinzip ist bisher unbekannt. Klinische Relevanz: Die Kenntnis des klinischen Bildes und der vermutlich fütterungsbedingten Zusammenhänge ist wichtig, um die Krankheit rechtzeitig zu erkennen. Das Diätergänzungsfuttermittel wurde vom Markt genommen, doch könnte die Verfütterung vergleichbar zusammen gesetzter Produkte ähnliche Krankheitserscheinungen hervorrufen.

Interleukin 12B gene polymorphism and apparent resistance to hepatitis C virus infection

Cellular immunity with interferon gamma production could have a role in protection from hepatitis C virus (HCV). Interleukin (IL)-12 is a key cytokine in promoting such anti-viral T helper 1 (Th1) responses. We hypothesized that a genetic background able to promote cellular responses may be associated with apparent protection from infection and have investigated the distribution of the functional 1188A/C polymorphism of IL-12B in HCV exposed but uninfected cases. The frequency of the high IL-12-producing C allele was determined by restriction enzyme genotyping in 76 exposed-uninfected individuals and 105 healthy controls. Overall, the C allele was found in 27.6% of exposed-uninfected cases compared with 16.7% of healthy controls [chi(2) = 6.3, P = 0.02, odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1-3.2]. CC genotype was found in 10.5% of exposed-uninfected cases compared with 0.9% controls (chi(2) = 9.3, P = 0.01, OR = 12, 95% CI = 1.5-100). Individuals at high risk of HCV infection yet who remain uninfected may be resistant in some way to infection. In our cohort of exposed-uninfected cases a genetic background of enhanced IL-12 production was associated with apparent resistance to HCV infection. This lends support to a central role for cellular immune responses in protecting from infection.

Application of the glutaraldehyde test in cattle

In a cohort study involving 62 cows from an experimental farm, the kinetics of the glutaraldehyde test (GAT) according to Sandholm (1974) was examined by testing samples of EDTA blood, lithium heparinate blood, serum, and plasma taken at various intervals. Total protein was measured in serum, and fibrinogen was determined in plasma. Gamma globulin was measured by electrophoresis. All glutaraldehyde tests were performed in duplicates, and the relation of the two results was used as measurement of precision. Optimal cut-off of the GAT time was determined as the zenith of the sum of sensitivity and specificity of various intervals for detecting combinations of gamma globulin and fibrinogen levels above 32 g/l. Precision was the best in EDTA blood. The relation between coagulation time and gamma globulin plus fibrinogen is best described by an exponential curve. The maximum value for the sum of sensitivity and specificity was found at 7 and 8 min. Seven days was the shortest interval observed between a negative test result (>15 min) and a strongly positive test result (<3 min). Twenty-one days was the shortest interval observed between a strongly positive test result and a negative test result. EDTA blood should be used for the GAT. A cut-off of 8 min yields the highest efficiency. Test results must be viewed in light of clinical findings.

Der angeborene Sehnenstelzfuß beim Kalb

Gegenstand und Ziel: Einleitend werden die sehr unterschiedlichen Überlegungen in der Literatur zur Ätiologie des angeborenen Sehnenstelzfußes (NMDC) des Kalbes beschrieben und diskutiert. In einer Feldstudie sollten die Inzidenz in landwirtschaftlichen Betrieben, Zusammenhänge mit dem Geburtsverlauf und die weitere Entwicklung betroffener Kälber untersucht werden. Material und Methoden: Innerhalb von 12 Monaten wurden ca. 70% aller neugeborenen Kälber aus 65 Betrieben (n = 1238) zwischen erstem und drittem Lebenstag hinsichtlich des Vorliegens einer NMDC untersucht. Kälber mit NMDC wurden wöchentlich kontrolliert, bis die Symptomatik verschwunden oder der Proband einer weiteren Untersuchung nicht mehr zugänglich war. Angaben über den Geburtsverlauf wurden erfragt. Ergebnisse: Bei 13,6% (n = 168) der untersuchten Kälber ließ sich eine NMDC feststellen (Grad I: 88,7%; Grad II: 11,3%; Grad III: 0%). In 90,5% der Fälle bestand die NMDC nur an den Vordergliedmaßen, bei 7,7% an Vorder- und Hintergliedmaßen und bei 1,8% nur an den Hintergliedmaßen. Männliche Tiere waren signifikant häufiger betroffen als weibliche und Kälber aus Zwillingsträchtigkeiten signifikant häufiger als Einlinge. In Hinterendlage geborene Kälber hatten signifikant häufiger eine NMDC als in Vorderendlage geborene. Schlussfolgerungen: Die Resultate sind mit der Vorstellung vereinbar, dass die Raumverhältnisse im Uterus bei der Entstehung der NMDC eine Rolle spielen. Bei knapp 90% der Tiere verschwand die Beugesehnenverkürzung ohne tierärztliche Behandlung. Klinische Relevanz: Die notwendigen Therapiemaßnahmen orientieren sich am Grad der NMDC. Geringgradige Verkrümmungen bedürfen keiner speziellen Behandlung. Die Therapieoptionen bei mittelgradig ausgeprägter NMDC (Aufkleben vorne überstehender Holzbrettchen auf die Klauensohlen, Stützverbände mit/ohne Tenotomie der Beugesehnen) werden detailliert beschrieben. Durch die Gabe von Oxytetracyclin (60 mg/kg KM, n = 10) ließ sich der Verlauf der NMDC nicht nachweislich beeinflussen.

Diagnostic accuracy of faecal calprotectin estimation in prediction of abnormal small bowel radiology

BACKGROUND

[corrected] Patients being investigated for symptoms of abdominal pain, diarrhoea and or weight loss often undergo small bowel radiology as part of their diagnostic workup mainly to exclude inflammatory bowel disease.

AIM

To assess and compare the utility of a single faecal calprotectin estimation to barium follow through as well as conventional inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein in exclusion of intestinal inflammation.

METHODS

Seventy-three consecutive cases undergoing barium follow through for investigation of symptoms of diarrhoea and or abdominal pain with or without weight loss were studied. The control group comprised 25 cases with known active Crohn's disease (positive controls), 26 normal healthy volunteers (negative controls) and 25 cases of irritable bowel syndrome diagnosed by Rome II criteria. Symptoms, erythrocyte sedimentation rate and C-reactive protein were recorded at recruitment and a single stool sample assayed for calprotectin within 7 days prior to or after barium follow through.

RESULTS

The median calprotectin value in the active Crohn's group, irritable bowel syndrome group and normal volunteers was 227 microg/g of stool, 19 and 10 microg/g respectively (P < 0.0001). A faecal calprotectin above a cut-off value of 60 microg/g was able to predict all nine cases with an abnormal barium follow through as well as all six cases with a normal barium follow through but with organic intestinal disease. The negative predictive value of a single calprotectin result below 60 microg/g of stool was 100% compared with 91% each for erythrocyte sedimentation rate > 10 mm and C-reactive protein > 6 mg/L and 84% for a combination of erythrocyte sedimentation rate and C-reactive protein in predicting absence of organic intestinal disease.

CONCLUSION

A single stool calprotectin value < 60 microg/g of stool obviates the need for further barium radiology of the small bowel, is more accurate than measurement of erythrocyte sedimentation rate or C-reactive protein and effectively excludes Crohn's disease or non-functional gastrointestinal disease.

The relationship between milk yield and the incidence of some diseases in dairy cows

Logistic regression models were used to examine the relationship between milk yield and incidence of certain disorders. Lactations (n = 2197) of 1074 Holstein-Friesian cows from 10 dairies (25 to 146 cows per dairy) in Lower Saxony were studied. The 305-d yield from the previous and current lactations served as the standards for milk yield. Eight disorder complexes were considered: retained placenta, metritis, ovarian cysts, mastitis, claw diseases, milk fever, ketosis, and displaced abomasum. Each disorder complex was modeled separately. In addition to milk yield, the influences of the lactation number, the calving season and the other disorder complexes were examined with the "herd" factor taken into account. A correlation between retained placenta, mastitis, and milk fever to milk yield during the previous lactation was found to be probable and for ketosis and displaced abomasum such a correlation was found to be possible. A connection to the yield in the current lactation was shown for ovarian cysts, claw diseases, and milk fever. No relationship to milk yield existed for metritis. An influence of the lactation number was also demonstrated in various models. Single models allowed a demonstration of the influences of both milk yield and lactation number. Limitations of the model types are discussed.

Role of activator site position and a distal UP-element half-site for sigma factor selectivity at a CRP/H-NS-activated sigma(s)-dependent promoter in Escherichia coli

Transcription initiation by the stress-associated sigma(S)-containing RNA polymerase holoenzyme (E sigma(S)) in Escherichia coli is often subject to complex regulation that involves multiple additional regulators and histone-like proteins. csiD is a stationary phase-inducible sigma(S)-dependent gene in E. coli that requires activation by cAMP-CRP (bound to a site centred at -68.5 nucleotides upstream of the transcriptional start site) and is positively modulated by the abundant nucleoid-associated proteins H-NS and Lrp. By shifting the CRP box to positions between -80.5 and -60.5, we could demonstrate that: (i) activation is equally helix phase dependent as at classic class I promoters; (ii) E sigma(S) prefers a CRP box location at -68.5/-70.5, whereas E sigma(70) is nearly inactive with such an arrangement; and (iii) with the CRP site moved to -60.5, transcription can be initiated efficiently by both holoenzymes. The csiD promoter region also contains a distal UP-element half-site located downstream of the CRP box, as demonstrated by mutational studies, in which this element was either eliminated or completed to a full UP-element. The UP-element half-site favours E sigma(S)-mediated expression, whereas with the full UP-element, nearly wild-type levels of csiD transcription were observed in the absence of sigma(S). Finally, we show that the two histone-like proteins, H-NS and Lrp, both act by influencing activation by cAMP-CRP, but do so by different mechanisms. In particular, H-NS directly or indirectly increases positional stringency for the CRP binding site. The implications of these findings with respect to sigma factor selectivity, activation mechanisms used by the two holoenzymes and the architecture of sigma(S)-dependent promoters are discussed.

Functional replacement of the essential ESS1 in yeast by the plant parvulin DlPar13

A functionally Pin1-like peptidyl-prolyl cis/trans isomerase (PPIase(1)) was isolated from proembryogenic masses (PEMs) of Digitalis lanata according to its enzymatic activity. Partial sequence analysis of the purified enzyme (DlPar13) revealed sequence homology to members of the parvulin family of PPIases. Similar to human Pin1 and yeast Ess1, it exhibits catalytic activity toward substrates containing (Thr(P)/Ser(P))-Pro peptide bonds and comparable inhibition kinetics with juglone. Unlike Pin1-type enzymes it lacks the phosphoserine or phosphothreonine binding WW domain. Western blotting with anti-DlPar13 serum recognized the endogenous form in nucleic and cytosolic fractions of the plant cells. Since the PIN1 homologue ESS1 is an essential gene, complementation experiments in yeast were performed. When overexpressed in Saccharomyces cerevisiae DlPar13 is almost as effective as hPin1 in rescuing the temperature-sensitive phenotype caused by a mutation in ESS1. In contrast, the human parvulin hPar14 is not able to rescue the lethal phenotype of this yeast strain at nonpermissive temperatures. These results suggest a function for DlPar13 rather similar to parvulins of the Pin1-type.

High-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity

BACKGROUND

The prognosis of patients with high-risk germ-cell cancer is poor. The toxicity and efficacy of first-line high-dose chemotherapy (HDCT) with stem-cell support was evaluated, following induction chemotherapy with BEP.

PATIENTS AND METHODS

Twenty patients with poor prognosis non seminomatous germ-cell tumour by the International Consensus prognostic criteria received induction with BEP followed by one cycle of HDCT (CEC) given with carboplatin (1800 mg/m2), etoposide (1800 mg/m2), and cyclophosphamide (140 mg/kg). Of the above 20 patients only 3 received a second cycle of HDCT. Peripheral blood stem cells were infused on day 0.

RESULTS

Twenty patients were assessable for toxicity and response. After a median follow-up of 27 months 15 patients (75%) are alive, 12 (60%) are disease free and 3 (15%) are alive with disease. Median survival has not been reached and overall survival at four years is 66% with a durable complete response rate of 50%. There were no deaths or cases of severe toxicity. Median time to a granulocyte count > 500/microl and platelets > 20,000/microl was 10 and 12 days respectively. Five patients have died from progressive disease 5-35 months after HDCT.

CONCLUSIONS

These results support the case of first-line HDCT. The excellent toxicity profile of BEP/CEC and the two-year overall survival of 78% are encouraging and support further the ongoing randomised US intergroup study evaluating high-dose CEC after BEP.

Isolation and characterization of two acyl-CoA-binding proteins from proembryogenic masses of Digitalis lanata Ehrh

Two acyl-CoA-binding-protein (ACBP) isoforms were isolated from proembryogenic masses of Digitalis lanata Ehrh. by column chromatography and preparative HPLC. The ACBPs had molecular masses of 9926 and 9997 Da, respectively. Partial sequence data indicated high similarity to each other and to ACBPs of other plant species such as Ricinus communis, Brassica napus and Arabidopsis thaliana. The isolated ACBPs bound palmitoyl-CoA with high affinity as determined by isoelectric-point shift.

Efficacy of an immune modulator in enzootic pneumonia of dairy calves

The objective of this cohort study was the evaluation of the efficacy of an immune modulator in the prophylaxis, metaphylaxis and treatment of enzootic bronchopneumonia (EBP). A total of 552 dairy calves on 13 farms were included. Groups of calves were included in the study if the prevalence of respiratory disease on the first visit was at least 50%, and the number of animals aged 2-16 weeks was at least 10. Controls were treated with a placebo. Animals of both groups were treated antibiotically if body temperature exceeded 39.5 degrees C. A clinimetric system was devised and used for classifying the animals into one of seven categories (healthy, beginning respiratory disease, acute BP, subacute BP, chronic BP, acute flare-up of chronic BP, and other disease). Animals were examined clinically on days 1, 3, 10, and 28. In animals treated prophylactically, the incidence of BP on day 10 was significantly higher (51%) than in those that received the placebo (31%). In animals treated metaphylactically, the average number of treatment days was significantly lower (2.86) than in the placebo group (3.81). In animals treated therapeutically, the incidence of EBP on day 10 was significantly lower than in the placebo group.

[The effectiveness of intravenous administration of large quantities of glucose in the treatment of bovine ketosis]

Glucose in a 40% (w/v) solution (200 g, 400 g or 600 g) was infused intravenously in clinically healthy cattle. On urinalysis, 13%, 19% and 26% respectively of the infused glucose was excreted. In cattle with elevated urinary ketone bodies, only the infusion of 400 or 600 g glucose led to a significant rise in the serum glucose concentration compared to initial values. Only the infusion of 600 g of glucose was followed by a significant decrease in serum beta-hydroxybutyrate 24 hours later compared to initial values. The present results indicate a possibility of improving the results of treatment of ketosis by infusion of high amounts of glucose.

[BHV-1 intradermal test in cattle]

Investigations concerning an intradermal test for the diagnosis of BHV 1 infection were carried out in 221 cattle. In 16% of cases the result of the test was dependent on the time the test was read (48 or 72 h). Fifteen per cent of the animals older than 9 months showed no reaction to the intradermal test though humoral antibodies against BHV 1 were detectable by ELISA. Intradermal injection of test antigen resulted in seroconversion in seronegative cattle. The antibodies remained detectable in the ELISA for about 3 to 6 weeks.

[Hysteroscopy as a diagnostic aid for uterine diseases of cattle]

A method for hysteroscopy in cattle, using a rigid tube for passage through the cervical canal, is described. Using this method, passage through the cervical canal is possible independent of the stage of the gynaecological cycles. The hysteroscopic findings of 105 examinations in cows are described and discussed.

[Computerized laboratory data management for health control in animal clinics and practices]

The organization of the flow of laboratory data is shown. Examples of application in sampling methods, the handling of data and the use of epidemiological methods are given.

West African dogs as a model for research on trypanotolerance

Autochthonous dogs from Liberia/West Africa were reared trypanosome-free and brought to West Berlin/germany. Together with Beagle dogs they were infected cyclically by tsetseflies with Trypanosoma congolense. While the European dogs died soon of the trypanosomal infection, the African dogs developed milder parasitaemias and remained clinically unaffected. The authors' opinion is, that this dog model could make a contribution to research on trypanotolerance.