Heritable defects in telomere and mitotic function selectively predispose to sarcomas

Cancer genetics has to date focused on epithelial malignancies, identifying multiple histotype-specific pathways underlying cancer susceptibility. Sarcomas are rare malignancies predominantly derived from embryonic mesoderm. To identify pathways specific to mesenchymal cancers, we performed whole-genome germline sequencing on 1644 sporadic cases and 3205 matched healthy elderly controls. Using an extreme phenotype design, a combined rare-variant burden and ontologic analysis identified two sarcoma-specific pathways involved in mitotic and telomere functions. Variants in centrosome genes are linked to malignant peripheral nerve sheath and gastrointestinal stromal tumors, whereas heritable defects in the shelterin complex link susceptibility to sarcoma, melanoma, and thyroid cancers. These studies indicate a specific role for heritable defects in mitotic and telomere biology in risk of sarcomas.

Phase I study of autolytic immunotherapy of metastatic neuroendocrine tumors using intralesional rose bengal disodium

4115

Background: Metastatic neuroendocrine neoplasms (mNEN) originating in the gastrointestinal tract are frequently slow growing yet both symptom and disease control remain important. Treatment options include resection, systemic somatostatin analogues (SSA), and systemic peptide receptor radionuclide therapy (PRRT). Additional options are needed; we have explored intralesional (IL) rose bengal disodium (PV-10), an investigational autolytic immunotherapy that can yield immunogenic cell death and disease-specific functional adaptive immunity. Methods: This phase 1 study evaluated safety, tolerability and impact on symptoms and biochemical markers resulting from IL PV-10 administered percutaneously to hepatic lesions in patients (pts) with progressive mNEN not amenable to resection or other potentially curative therapy. Eligible lesion(s) were 1.0 - 3.9 cm in longest diameter with amount of PV-10 administered proportional to size. Cohort 1 (n = 6 pts) received PV-10 to a single lesion per treatment cycle; Cohort 2 (n = 6) could receive injection to multiple lesions per treatment cycle. Pts could receive further PV-10 ≥6 weeks after prior injection. The primary endpoint was safety. Secondary endpoints included objective response rate (ORR) assessed by contrast enhanced CT (RECIST 1.1) and 68Ga-DOTATATE PET, biochemical response (CgA) and patient-reported outcome (EORTC QLQ-C30 and GI.NET21 QOL instruments). Results: Twelve pts were enrolled, 50% male, median age 66 yrs (range 47-79). Primary sites: 7 small bowel, 2 pancreas, 1 caecal, 2 unknown; grade: Gd1 = 5, Gd2 = 7. All pts had received SSA and PRRT as part of previous therapy and all had symptomatic, progressive disease. Median CgA was 1585 (range 35-10370). One lesion was injected per cycle for all 12 pts; none were suitable for multiple injections. One pt received 4 sequential PV-10 treatment cycles, 3 received 2 cycles, and 8 received 1 cycle. Toxicity was consistent with experience in other hepatic malignancies: post-procedure pain was reported by most pts; grade 3 photosensitivity reaction occurred in 1 pt; and grade 1 elevation of hepatic enzymes attributed to PV-10 occurred in 2 pts, resolving by day 7. Additionally, carcinoid flare occurred in 1 pt. ORR of injected lesions was 42%; patient-level disease control was 84%. Estimated PFS was 9.2 months; median OS was 22.5 months. CgA remained stable in 10 pts and upregulation of NK and activated CD4+ T lymphocytes was observed post-injection. QOL data at months 1 and 3 showed stable or improved carcinoid symptoms and global health status in 9 pts. Conclusions: PV-10 elicited no safety concerns with encouraging evidence of both local and systemic disease and symptom control in a heavily pre-treated population. Multiple cycles were delivered safely in suitable patients. Adaptive immune upregulation is consistent with other solid tumors and supports potential systemic benefit. Clinical trial information: NCT02693067.

Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 2 — Prenatal, Fetal, and Neonatal Outcomes

Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes.

Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26.

Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females).

Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.

Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 1 — Maternal and Paternal Outcomes

Background: Anecdotally, infertility concerns among serving female Australian Defense Force (ADF) members and veterans are perceived to be prevalent, but precise data are lacking. This is the first of two papers that identify reproductive, pregnancy, and infant outcomes in an exclusively Australian military cohort. This initial paper aims to describe maternal and paternal occupation and fertility characteristics of a group of ADF members who deployed to the Middle East during the period 2001–2010.

Methods: Utilizing the Middle East Area of Operations Census Study data set, a descriptive analysis was performed on the demographic and clinical variables of the cohort, where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the population. Sociodemographic data and clinical data, including maternal/paternal outcomes, were reported.

Results: The self-reported infertility rate was 9%, which was significantly lower than the reported infertility rate in the comparative Australian (non-military) population. All other outcomes were comparable to the Australian population and within normal limits.

Conclusions: This survey presents a generally reassuring picture of reproductive health for men and women serving in the ADF with regard to the risk of infertility, pregnancy loss, and perinatal outcomes, although the basis for fertility concerns requires further investigation.

Cohort 1 results of a phase I study of autolytic immunotherapy of metastatic neuroendocrine neoplasms using intralesional rose bengal disodium

e16694

Background: Metastatic neuroendocrine neoplasms (mNEN’s) originating in the gastrointestinal tract are frequently slow growing yet both symptom and disease control remain important. Treatment options include resection, chemoablation, systemic somatostatin analogues (SSA) or peptide receptor radionuclide therapy (PRRT), but additional options are needed, especially when available options have been exhausted. Intralesional (IL) rose bengal disodium (PV-10), an autolytic immunotherapy under development for solid tumors, is being investigated as a potential option for treatment-refractory patients (pts) with hepatic metastases. Methods: This phase 1 study is evaluating the safety, tolerability and objective response resulting from percutaneous administration of PV-10 in 12 pts with progressive mNEN refractory to SSA and PPRT; pts must have at least one injectable hepatic lesion (1.0-3.9 cm in longest diameter) not amenable to resection or other potentially curative therapy. In Cohort 1 (n = 6) pts received PV-10 to a single hepatic lesion per treatment cycle, and could receive PV-10 to additional uninjected hepatic lesions ≥6 weeks after prior injection. The primary endpoint is safety. Secondary endpoints include objective response rate assessed by independent review of contrast enhanced CT and by 68Ga-DOTATATE PET. Results: Cohort 1 has fully enrolled, with 4 of 6 pts male, median age 65 yrs, range 47-72. Primary sites were: small bowel 3, pancreas 2, caecal 1. NET grade: Gd1 = 5, Gd2 = 1. All pts had progressed on prior SSA and PRRT. Median baseline CgA was 645 (range 30-2819). One pt received 4 PV-10 treatment cycles, 1 received 2 cycles, and 4 received a single cycle. Toxicity was acceptable, including transient pain post procedure, carcinoid flare and nausea. A partial response of injected lesions was observed in 50% of pts (injected lesion progression in 1 pt), with an overall response of stable disease achieved in 84% of pts by RECIST 1.1 (progressive disease in 1 pt). Progression free survival (PFS) was not reached by CT (range 2.4-25.3+ months), and was 6.1 months by PET. Median overall survival (OS) was ≥22.5 months, with three subjects alive at the data cut-off of Jan 2020 (range 18.1-33.8 months). Conclusions: Hepatic IL PV-10 elicited no safety concerns with encouraging evidence of both local response of injected tumors and prolonged systemic disease control in some pts. Enrolment to Cohort 2 is nearing completion where an additional 6 pts may receive injection of multiple lesions per treatment cycle. Clinical trial information: NCT00986661 .

Cost-effectiveness analysis of imaging surveillance in stage II and III extremity soft tissue sarcoma: an Australian perspective

Background

Surveillance imaging is used to detect local and/or distant recurrence following primary treatment of localised soft tissue sarcoma (STS), however evidence supporting optimal surveillance modality or frequency is lacking. We used prospectively collected sarcoma data to describe current surveillance imaging practice in patients with AJCC stage II and III extremity STS and evaluate its cost-effectiveness.

Methods

From three selected Australian sarcoma referral centres, we identified patients with stage II and III extremity STS treated between 2009 and 2013. Medical records were reviewed to ascertain surveillance imaging practices, including modality, frequency and patient outcomes. A discrete event simulation model was developed and calibrated using clinical data to estimate health service costs and quality adjusted life years (QALYs) associated with alternative surveillance strategies.

Results

Of 133 patients treated for stage II and III extremity STS, the majority were followed up with CT chest (86%), most commonly at 3-monthly intervals and 62% of patients had the primary site imaged with MRI at 6-monthly. There was limited use of chest-X-ray. A discrete event simulation model demonstrated that CT chest screening was the most cost effective surveillance strategy, gaining additional QALYs at a mean incremental cost of $30,743. MRI alone and PET-CT alone were not cost-effective, whilst a combined strategy of CT + MRI had an incremental cost per QALY gained of $96,556.

Conclusions

Wide variations were observed in surveillance imaging practices in this high-risk STS cohort. Modelling demonstrated the value of CT chest for distant recurrence surveillance over other forms of imaging in terms of cost and QALYs. Further work is required to evaluate cost-effectiveness in a prospective manner.

Epidemiological trends of dermal sarcoma in Australia

Background: Sarcomas comprise a heterogenous group of malignant tumours of mesenchymal origin and can arise in the skin. Definitive management of skin sarcoma usually entails surgical resection with wide margins, often requiring reconstruction. The incidence and demographics of these neoplasms in Australia are poorly understood. Method: Incidence, gender and age distribution data for skin sarcomas for the period 1982–2009 were obtained from the Australian Cancer Database (ACD). Morphology and topographical region coding via the International Classification of Diseases for Oncology third edition (ICD-O-3)1 were used to identify the data.Results: A total of 5453 cases of skin sarcoma in the Australian population were identified over the 28-year period. Anatomically, 1610 cases (29%) occurred on the limbs, 1416 (26%) on the head and neck area, 957 (18%) on the trunk and 1470 (27%) had an unspecified skin origin. Overall incidence was 2.09 per 100,000 population. Males were more commonly affected (70%), most commonly in the 30–49 years and 70+ years age groups. The most common pathological subtypes were fibromatous sarcoma (including dermatofibrosarcoma protuberans), Kaposi’s sarcoma and pleomorphic dermal sarcoma.Conclusion: The Australian Cancer Database data used to describe the pattern and epidemiological trends for skin sarcoma in Australia demonstrated variation from international trends and highlight the need for further research into the aetiology of these tumours.

Abstract 41: XI-006 induces potent p53-independent apoptosis in Ewing sarcoma

Despite aggressive multi-modal treatment strategies, limited improvement in overall survival rates for patients diagnosed with Ewing sarcoma, the second most prevalent solid bone tumor observed in children and young adolescents, has been achieved over the past thirty years. As such, new targeted therapies are urgently required particularly for those sarcoma patients with recurrent or metastatic disease. Overexpression of MDM4, a major transcriptional regulator of the TP53 tumour suppressor has been documented in a substantial proportion of Ewing, Synovial and Osteosarcomas (>30%). For this reason, we have examined the molecular and cellular responses of cultured Ewing and Osteosarcoma cell lines following treatment with XI-006 (NSC207895), a small molecule 4-nitrobenzofuroxan derivative MDM4 transcriptional inhibitor.

XI-0006 treatment of Ewing and osteosarcoma cell lines (n=11) resulted in rapid and potent apoptosis at low nano-molar concentrations specifically in Ewing sarcoma cell lines (48hr IC50: 0.098-1.61µM). Importantly, the viability of normal human fibroblasts (IMR90) remained unaffected at these low nano-molar concentrations (48hr IC50: 6.80µM). Unexpectedly, apoptotic response was not dependent on MDMX mRNA and protein levels or TP53 status. Alkaline/neutral comet and γH2AX immunofluorescence assays revealed that the cytotoxic effects of XI-006 at low nano-molar concentrations could not be attributed to the induction of DNA damage. RNA expression analysis of XI-006 treated cell lines revealed that the mechanism of action of XI-006 could be attributed to the inhibition of cell division and cycle regulators such as KIF20A and GPSM2. XI-006 was also shown to synergise with current Ewing sarcoma chemotherapeutic protocols, Doxorubicin, Etoposide and Actinomycin D in vitro. Furthermore, combinatorial treatment with Olaparib led to a maximum 56.3% increase in apoptosis compared to XI-006 alone, due to the down-regulation of Mre11.

Our pre-clinical findings suggest that XI-006 represents a novel therapeutic intervention for the treatment of Ewing sarcoma, and warrants further pharmacokinetic and pharmacodynamic investigations of XI-006 in vivo.

Citation Format: Kathleen Pishas, Susan Neuhaus, Mark Clayer, Gelareh Farshid, Alexander Staudacher, David Callen. XI-006 induces potent p53-independent apoptosis in Ewing sarcoma. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Integrating Clinical Genomics and Cancer Therapy; Jun 13-16, 2015; Salt Lake City, UT. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(1_Suppl):Abstract nr 41.

[Patient safety in anesthesiology : Multimodal strategies for perioperative care]

The concept of patient safety is more of a presence in modern day medicine than ever before. All measures and processes aiming at preempting and preventing critical incidents and accidents in patient care are collectively grouped under this concept. With the Declaration of Helsinki in 2010 modern anesthesiology has undertaken a fundamental role in the clinical implementation and perioperative clinicians are confronted with a multitude of theories, models, methods and tools targeted at improving or facilitating optimized patient safety. One of the biggest challenges lies in their synergistic combination to create a functioning concept for perioperative risk management while also incorporating individual strengths and weaknesses. The aim of the present paper is to provide a structured overview of the various components presently available for increasing perioperative patient safety.

The attitudes of people with sarcoma and their family towards genomics and incidental information arising from genetic research

Purpose

The study aimed to examine attitudes of individuals diagnosed with sarcoma and their family members towards genetics, genomic research and incidental information arising as a result of participating in genetic research.

Methods

A questionnaire was administered to 1200 individuals from the International Sarcoma Kindred Study (ISKS). Respondents were divided into three groups: individuals affected with sarcoma (probands), their spouses and family members.

Results

Approximately half of all research participants felt positively towards new discoveries in human genetics. Overall, more were positive in their attitudes towards genetic testing for inherited conditions (60%) but family members were less so. Older participants reported more highly positive attitudes more often than younger participants. Males were less likely to feel positive about new genetic discoveries and more likely to believe they could modify genetic risk by altering lifestyle factors. Almost all ISKS participants believed participants would like to be given ancillary information arising as a result of participating in genetic research.

Conclusions

The only difference between the study groups was the decreased likelihood of family members being highly positive about genetic testing. This may be important if predictive testing for sarcoma becomes available. Generally ISKS research participants supported the notion of returning incidental genetic information to research participants.

Quasiballistic transport of Dirac fermions in a Bi2Se3 nanowire

Quantum coherent transport of surface states in a mesoscopic nanowire of the three-dimensional topological insulator Bi(2}Se(3) is studied in the weak-disorder limit. At very low temperatures, many harmonics are evidenced in the Fourier transform of Aharonov-Bohm oscillations, revealing the long phase coherence length of spin-chiral Dirac fermions. Remarkably, from their exponential temperature dependence, we infer an unusual 1/T power law for the phase coherence length L(φ)(T). This decoherence is typical for quasiballistic fermions weakly coupled to their environment.

Melanoma follow up: time to generate the evidence

Research is needed into current melanoma follow-up practices and their implications for patients and society. We highlight the need and suggest a way forward.

Part-time general surgical training in South Australia: its success and future implications (or: pinnacles, pitfalls and lessons for the future)

BACKGROUND

Flexible training options are sought by an increasing number of Australasian surgical trainees. Reasons include increased participation of women in the surgical workforce, postgraduate training and changing attitudes to family responsibilities. Despite endorsement of flexible training by the Royal Australasian College of Surgeons and Board in General Surgery, part-time (PT) training in General Surgery in Australia and New Zealand is not well established. A permanent 'stand-alone' PT training position was established at the Royal Adelaide Hospital in 2007 under the Surgical Education and Training Program. This position offered 12 months of General Surgical training on a 0.5 full-time (FT) equivalent basis with pro rata emergency and on-call commitments and was accredited for 6 months of General Surgical training. This paper reviews the PT training experience in South Australia.

METHODS

De-identified logbook data were obtained from the South Australian Regional Subcommittee of the Board in General Surgery with consent of each of the trainees. Totals of operative cases were compared against matched FT trainees working on the same unit.

RESULTS

Overall, PT trainees achieved comparable operative caseloads compared with their FT colleagues. All trainees included in this review have subsequently passed the Royal Australasian College of Surgeons Fellowship Examination in General Surgery and returned to FT workforce positions.

CONCLUSION

This paper presents two validated models of PT training. Training, resource and regulatory requirements and individual and institutional barriers to flexible training are substantial. Successful PT models offer positive and beneficial training alternatives for General Surgical trainees and contribute to workforce flexibility.

Increased parasite resistance and recurrent airway obstruction in horses of a high-prevalence family

BACKGROUND

Equine recurrent airway obstruction (RAO) shares many characteristics with human asthma. In humans, an inverse relationship between susceptibility to asthma and resistance to parasites is suspected.

HYPOTHESIS/OBJECTIVES

Members of a high-incidence RAO half-sibling family (F) shed fewer strongylid eggs compared with RAO-unaffected pasture mates (PM) and that RAO-affected horses shed fewer eggs than RAO-unaffected half-siblings.

ANIMALS

Seventy-three F and 73 unrelated, age matched PM.

METHODS

Cases and controls kept under the same management and deworming regime were examined. Each individual was classified as RAO affected or RAO unaffected and fecal samples were collected before and 1-3 weeks and 3 months after deworming. Samples were analyzed by combined sedimentation-flotation and modified McMaster methods and classified into 3 categories of 0 eggs per gram of feces (EpG), 1-100 EpG, and > 100 EpG, respectively.

RESULTS

PM compared with RAO-affected F had a 16.7 (95% confidence interval [CI]: 2.0-136.3) times higher risk for shedding > 100 EpG compared with 0 EpG and a 5.3 (95% CI: 1.0-27.4) times higher risk for shedding > 100 EpG compared with 0 EpG. There was no significant effect when RAO-unaffected F were compared with their PM. RAO-unaffected compared with RAO-affected offspring had a 5.8 (95% CI: 0.0-1.0) times higher risk for shedding 1-100 EpG. Age, sex, breed, and sharing pastures with other species had no significant confounding effects.

CONCLUSION AND CLINICAL IMPORTANCE

RAO is associated with resistance against strongylid parasites in a high-prevalence family.

Evaluation and comparison of two prognostic scores and the physicians’ estimate of survival in terminally ill patients

Background

Method

Results

Discussion

A Description of the Standardized Measurement Procedures and Recommended Threshold Limit Values for Biological Hazards in Germany

On the basis of EU directives 89/391/EEC (to encourage improvements in the safety and health of workers at work) and 2000/54/EC (on the protection of workers from risks related to exposure to biological agents at work), biological hazards at work have to be assessed and preventive measures have to be introduced in all member states of the EU. In Germany, national legislation (Biological Agents Ordinance - BioStoffV and Technical Rules on Biological Agents, TRBA) and recommendations of workers' compensation boards define standardized methods for the assessment of airborne mold, bacteria, and endotoxins. This article describes policies and practices in Germany for measurement of airborne bioaerosols and for interpretation of measurements relative to the standards. As an example, methods and results of measurements in agriculture are shown. The standardized measurement procedures proved suitable for use in livestock buildings. The results of the exploratory measurements in different livestock buildings confirmed the often high concentrations of airborne biological hazards in agriculture that are reported in the literature.

An unusual case of port site seeding

We present an unusual case of a port site tumor from a colonic adenocarcinoma following laparoscopic cholecystectomy. A 66-year-old woman with a previous renal transplant underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis. Three months later, she re-presented with pain localized to the right lateral port wound. Subsequent investigation revealed an adenocarcinoma in the ascending colon with no evidence of local spread or liver metastases. The patient was enrolled in the ALCCAS trial (an Australasian multicenter prospective randomized clinical study comparing laparoscopic and conventional open surgical treatments of colon cancer in adults) and randomized to the laparoscopic arm. At laparoscopy, nodules of tumor were located at the sites of the previous right flank and umbilical trocar sites. The procedure was converted to an open hemicolectomy with excision of port sites. To our knowledge, only one other case of a colon carcinoma metastasizing to a port site following laparoscopic cholecystectomy has been reported. This case illustrates a number of points: (a) This was an advanced tumor at the time of diagnosis and was undoubtedly present at laparoscopic cholecystectomy. (b) This tumor was not manipulated at the time of laparoscopic cholecystectomy. (c) The patient was immunosuppressed at the time of laparoscopic cholecytstectomy. (d) The patient developed clinical recurrence in her laparotomy wound within 3 months of her open procedure. This case supports current arguments that the etiology of port site metastases is likely to be mulifactorial.

[Typing of 17 porcine enterovirus isolates from polio encephalomyelitis cases during the years 1983-1991]

Seventeen strains of porcine enteroviruses (PEV) were isolated from organs of 119 pigs with symptoms of polioencephalomyelitis submitted to the State Veterinary Institute Arnsberg/Westphalia between 1983 and 1991. 15 isolates originated from the central nervous system and 2 from organ suspensions made up of a brain-spleen-pool and a lung-spleen-lymph node-pool, respectively. Isolates were assigned to 7 PEV types which were present at the following frequencies: PEV1: 2x; PEV2: 6x; PEV4: 3x; PEV5: 1x; PEV6: 2x; PEV 12: 1x; PEV 13: 2x. Mortality rates of affected groups exhibited an age-dependent curvilinear relationship suggesting that the PEV involved possessed a rather similar low to medium grade neurovirulence, irrespective of type. Exceptions were 1 herd with 100% mortality at the age of 10-18 weeks from which PEV2 strain 6793/83 was isolated (described earlier) and a second herd with 18% mortality at the age of 14-18 weeks from which PEV types 1, 2 and 4 were recovered. Sensitivity of 5 cell lines for the isolation of PEV was compared. Rates of isolation from organ suspensions which had proved positive in any of the cell lines tested were as follows: PS-EK: 77%; IB-RS-2: 63%; ST: 56%; PK-15: 47%; BHK21 (CT): 10%.

Grouping of porcine enteroviruses by indirect immunofluorescence and description of two new serotypes

Porcine enteroviruses (PEV) types 1-11 were assigned to three serologic groups by indirect immunofluorescence (IIF). Serotype group I consists of PEV types 1-7 and 11 and is correlated with CPE-type I. Serotype group II is represented by PEV type 8, producing CPE-type II, while PEV types 9 and 10 are classified as serotype group III and cause CPE-type III. Three PEV isolates from the central nervous system of pigs with polioencephalomyelitis were assigned to serotype group I by IIF but to none of the established 11 serotypes by cross-neutralization. It is concluded that these isolates are representatives of two new PEV types for which the designation PEV12 and 13 is suggested.

Hippocampal slices of kindled rats reveal calcium involvement in epileptogenesis

Daily repeated tetanic electrical stimulation (kindling) of the brain may cause a long term enhancement of synaptic transmission and epileptiform activity of progressive severity and generalisation, eventually leading to spontaneous seizures. Evidence for a cellular mechanism underlying kindling has been obtained in vitro in slices from the hippocampus of kindled rats. A marked enhancement in extracellular calcium changes, induced by electrical stimulation or by iontophoresis of excitatory aminoacids was found in kindled tissue. This implies that changes in dendritic calcium conductances are involved in kindling epileptogenesis.