Production study of Fr, Ra and Ac radioactive ion beams at ISOLDE, CERN

The presented paper discusses the production of radioactive ion beams of francium, radium, and actinium from thick uranium carbide (UCx ) targets at ISOLDE, CERN. This study focuses on the release curves and extractable yields of francium, radium and actinium isotopes. The ion source temperature was varied in order to study the relative contributions of surface and laser ionization to the production of the actinium ion beams. The experimental results are presented in the form of release parameters. Representative extractable yields per μ C are presented for222 - 231 Ac, several Ra and Fr isotopes in the mass ranges 214 ≤ A ≤ 233 and 205 ≤ A ≤ 231 respectively. The release efficiency for several isotopes of each of the studied elements was calculated by comparing their yields to the estimated in-target production rates modeled by CERN-FLUKA. The maximal extraction efficiency of actinium was calculated to be 2.1(6)% for a combination of surface ionization using a Ta ion source and resonant laser ionization using the two-step 438.58 nm, and 424.69 nm scheme.

QT Prolongation: Psychotropic medication versus illicit drugs

Introduction

Countless substances used for their psychotropic effects may induce adverse cardiac effects, such as QT prolongation. This category of substances holds illicit drugs as well as medications, with their effects influenced by dosage, concomitant use and patient specific factors. The appraisal of cardiac consequences is essential as delayed repolarization may lead to the rare but potentially deadly polymorphic ventricular tachycardia.

Objectives

The goal of this presentation is to underscore the cardiac risks associated with both medication use and substance abuse in order to ensure the suitable psychopharmacological treatment, especially in particular situations of drug using patients.

Methods

The subject of the presentation is a 17-year-old female adolescent hospitalized in our clinic, with multiple substance abuse, as seen in qualitative multidrug test (cannabis, amphetamines, ecstasy, barbiturates, benzodiazepines), previously under complex treatment prescribed by an adult psychiatrist (3 atypical antipsychotics, 1 selective serotonin reuptake inhibitor, 1 anticonvulsant, 1 benzodiazepine). Specialty literature has been reviewed concerning the cardiac effects of both the abuse substances and the psychiatric medications.

Results

Multiple drugs involved may cause a myocardial repolarization delay, the patient having a QTc of 508 msec at the admission. Consequent to parenteral fluids and treatment managing, ECG revealed a decrease to 379 msec 7 days later in the stay. This finding could not be viewed solely as caused by drug use, psychiatric medication or individual factors, but rather as their aggregation.

Conclusions

Psychotropic substances use may lead to QT prolongation, which calls for close cardiac supervision whenever patient’s behaviour warrants or when pharmacologic intervention is required.

Disclosure

No significant relationships.

Sympathetic renal denervation treatment in resistant hypertension: one-year follow-up

Aims

A comparison influence of renal denervation versus pharmacological treatment with sympathetic nervous system blockers on blood pressure in patients with resistant hypertension.

Methods

125 patients with resistant hypertension without comorbidities after a 3-week standardized treatment with Losartan 100 mg, Amlodipine 10 mg and Indapamid 1,5 mg and confirmation of their resistance were randomly assigned into three groups, depending on medication supplemented to previously administered: IM group – selective I1-imidazoline agonist Moxonidine, IIB group – cardioselective beta-blocker Bisoprolol and IIID group – renal artery denervation. Patients were assessed by ambulatory blood pressure monitoring at baseline, 3, 6 and 12 month follow-up. The compliance to drug treatment was confirmed by 8-item Morisky Medication Adherence Scale. Renal denervation was performed with a Symplicity Spyral catheter.

Results

The mean 24 hour systolic blood pressure (SBP m/24 h) at baseline were 179.0±2.02 mmHg in IM group versus 177.96±2.44 mmHg in IIB group and 176.92±1.97 mmHg in IIID group, p>0.05. Statistically significant dynamics was recorded starting with 3 months of evaluation in all three groups, the group of patients undergoing denervation of the renal arteries demonstrating a net superior effect compared with pharmacological treatment: −6.48±0.81 mmHg in I M group versus −6.2±0.88 mmHg in II B group and −23.28±1.9 mmHg in III D group, p<0.001. The beneficial effect was maintained until the end of the study, when in observational group supplemented with Moxonidine SBP m/24 h were 159.6±1.72 mmHg with a total reduction of −19.9±0.7 mmHg from baseline, in Bisoprolol group −164.08±1.93 mmHg with a reduction of −13.88±1.13 mmHg and 141.76±0.77 mmHg in renal denervation group with a total reduction of −35.16±2.23 mmHg, p<0.001.

The mean 24 hour diastolic blood pressure (DBP m/24 h) increased at baseline in all three groups (105.52±1.28 mmHg in IM versus 108.6±1.6 mmHg in IIB and 107.24±0.92 mmHg in IIID, p>0.05) similar to SBP m/24 h noted a significantly reduction at 3 month follow-up: −4.8±0.96 mmHg in IM group versus −3.64±0.47 mmHg in IIB group and −12.08±0.63 mmHg in IIID group, p<0.001. The maximum reduction in DBP m/24 h were registered at 12 month follow-up, a comparative analyses of dynamics between groups showing a presence of statistical difference due to superiority of renal denervation treatment in amelioration of this parameter: −13.68±0.83 mmHg in IM group versus −10.72±0.64 mmHg in IIB group and −20.2±1.28 mmHg in IIID group, p<0.001.

Conclusions

The application of all three treatment regimens has been shown to be effective in reducing SBP and DBP values m/24 hours in patients with resistant hypertension, with a superior but comparable effect of Moxonidine to Bisoprolol and the absolute superiority of renal denervation treatment versus both pharmacological treatment regimens.

Funding Acknowledgement

Type of funding source: None

Nonquenched Isoscalar Spin-M1 Excitations in sd-Shell Nuclei

Differential cross sections of isoscalar and isovector spin-M1 (0(+)→1(+)) transitions are measured using high-energy-resolution proton inelastic scattering at E(p)=295  MeV on (24)Mg, (28)Si, (32)S, and (36)Ar at 0°-14°. The squared spin-M1 nuclear transition matrix elements are deduced from the measured differential cross sections by applying empirically determined unit cross sections based on the assumption of isospin symmetry. The ratios of the squared nuclear matrix elements accumulated up to E(x)=16  MeV compared to a shell-model prediction are 1.01(9) for isoscalar and 0.61(6) for isovector spin-M1 transitions, respectively. Thus, no quenching is observed for isoscalar spin-M1 transitions, while the matrix elements for isovector spin-M1 transitions are quenched by an amount comparable with the analogous Gamow-Teller transitions on those target nuclei.

Observation of the β-delayed γ-proton decay of (56)Zn and its impact on the Gamow-Teller strength evaluation

We report the observation of a very exotic decay mode at the proton drip line, the β-delayed γ-proton decay, clearly seen in the β decay of the T_{z}=-2 nucleus ^{56}Zn. Three γ-proton sequences have been observed after the β decay. Here this decay mode, already observed in the sd shell, is seen for the first time in the fp shell. Both γ and proton decays have been taken into account in the estimation of the Fermi and Gamow-Teller strengths. Evidence for fragmentation of the Fermi strength due to strong isospin mixing is found.

Observation of low- and high-energy Gamow-Teller phonon excitations in nuclei

Gamow-Teller (GT) transitions in atomic nuclei are sensitive to both nuclear shell structure and effective residual interactions. The nuclear GT excitations were studied for the mass number A = 42, 46, 50, and 54 "f-shell" nuclei in ((3)He, t) charge-exchange reactions. In the (42)Ca → (42)Sc reaction, most of the GT strength is concentrated in the lowest excited state at 0.6 MeV, suggesting the existence of a low-energy GT phonon excitation. As A increases, a high-energy GT phonon excitation develops in the 6-11 MeV region. In the (54)Fe → (54)Co reaction, the high-energy GT phonon excitation mainly carries the GT strength. The existence of these two GT phonon excitations are attributed to the 2 fermionic degrees of freedom in nuclei.

A pirinixic acid derivative (LP105) inhibits murine 5-lipoxygenase activity and attenuates vascular remodelling in a murine model of aortic aneurysm

BACKGROUND AND PURPOSE Arachidonic acid derivatives play a central role in inflammation processes. Arachidonic acid is metabolized by several enzymes, particularly cyclooxygenases (COX), 5-lipoxygenase (5-LOX) and microsomal prostaglandin E-synthase-1 (mPGES-1) to pro-inflammatory mediators. EXPERIMENTAL APPROACH We determined the effect of LP105, a pirinixic acid derivative which acts as inhibitor of 5-LOX, COX and mPGES-1, on aortic aneurysm development in mice and on 5-LOX activity in murine monocytes. KEY RESULTS In a monocyte cell line (RAW264.7), LP105 inhibited 5-LOX in whole cells (IC(50) : 1-3 µM) and in supernatants (IC(50) : ∼10 µM). Oral administration of LP105 to mice resulted in therapeutic tissue and plasma levels. Aortic aneurysms were induced in ApoE(-/-) mice by angiotensin II (AngII) and LP105 (5 mg·day(-1) per animal) was co-administered to a subgroup. Compared with animals receiving AngII alone, the LP105+AngII group showed a lower heart rate, a trend towards reduced heart to body weight ratio but similar hypertensive responses. AngII alone significantly increased aortic weight and diameter but co-treatment with LP105+AngII prevented these changes. LC/MS-MS studies revealed increased 15-hydroxytetraenoic acid (15-HETE) and 14,15-epoxyeicosatrienoic acid (14,15-EET) plasma levels in LP105-treated animals. In the murine kidney, mRNAs of EET-generating or metabolizing enzymes and of 5-LOX and 15-LOX were unaffected by LP105. LP105 also did not inhibit the EET-metabolizing soluble epoxide hydrolase. CONCLUSIONS AND IMPLICATIONS LP105 was a potent inhibitor of monocyte 5-LOX and reduced AngII-induced vascular remodelling in mice. A shift of arachidonic acid metabolism to the protective EET pathway may contribute to the beneficial effects of LP105.

Abstract PD01-08: Decoding the Transcriptional Landscape of Triple-Negative Breast Cancer Using Next-Generation Whole Transcriptome Sequencing

Background: Triple-negative breast cancer (TNBC) has been plagued by the absence of targeted therapies. Discovery of therapeutic targets in TNBC has in part, been hampered by an inadequate understanding of the transcriptional biology of the normal breast as an optimal comparator. Using next-generation sequencing, we embarked on a study to compare the transcriptomes of TNBC and normal breast to comprehensively identify novel targets by analyzing all full length transcripts expressed in these tissues.

Methods: Normal breast tissues from healthy pre-menopausal volunteers with no history of disease were procured from the Susan G. Komen for the Cure® Tissue Bank at the IU Simon Cancer Center. To eliminate bias from stromal tissue, normal tissues were laser capture microdissected for ductal epithelium. cDNA libraries from 10 TNBC tumors and 10 normal breast tissues were sequenced on an Applied Biosystems (AB) SOLiD3 sequencer using 50bp fragment runs. For gene expression, mapping of reads to the genome was performed using the AB BioScope 1.2 Pipeline and outputs imported into Partek Genomics Suite for analysis. In Partek, mapped reads were cross-referenced against known genes from the UCSC database followed by statistical comparison of RPKM values for each gene between TNBC and normal. Dimensionality reduction analyses (PCA & Hierarchical clustering) and identification of Novel Transcribed Regions were also performed in Partek, whereas construction of gene networks was performed using Ingenuity Pathway Analysis. To identify gene fusions, partially mapped reads were interrogated utilizing a novel algorithm that searched for reads spanning exons from two different genes. Fusions that were supported by at least 3 reads (of which 2 had to be unique) were considered candidates and were subsequently validated. Results/Discussion: Sequencing produced 1.1 billion reads equaling 57.3GB of data of which 36.0GB (63%) mapped to the human genome. In comparing RPKM values between TNBC and Normal, we report 7140 RefSeq Genes, 22 pre-miRNAs, 109 lincRNA exons, and 15 ultraconserved regions that were differentially expressed between these tissues (FDR<0.01). Biological interpretation of these results reveals upregulation of genes and miRNAs involved in DNA repair, angiogenesis, and inhibitors of Estrogen Receptor-alpha. Some previous drug targets (e.g. EGFR and c-kit) were not found to be upregulated here which may explain lack of clinical success to date. Conversely, PARP was significantly upregulated and early trial results suggest a strong signal for efficacy with inhibition of PARP. We also surveyed the genome for Novel Transcribed Regions (NTRs), defined as areas of significant transcription where no annotated gene is present. When comparing between TNBC and Normal, we report 6408 NTRs to be differentially expressed (FDR<0.01). Lastly, when analyzing the dataset for gene fusions, we identified several gene fusions in the TNBC samples, though no individual fusion was present in more than one sample.

Conclusion: We report an extensive comparison of the transcriptomes of TNBC and normal ductal epithelium. We identified numerous genes previously unknown to be dysregulated in TNBC that can be utilized for therapeutic discovery.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD01-08.

Isospin character of the pygmy dipole resonance in 124Sn

The pygmy dipole resonance has been studied in the proton-magic nucleus 124Sn with the (α, α'γ) coincidence method at Eα=136 MeV. The comparison with results of photon-scattering experiments reveals a splitting into two components with different structure: one group of states which is excited in (α, α'γ) as well as in (γ, γ') reactions and a group of states at higher energies which is only excited in (γ, γ') reactions. Calculations with the self-consistent relativistic quasiparticle time-blocking approximation and the quasiparticle phonon model are in qualitative agreement with the experimental results and predict a low-lying isoscalar component dominated by neutron-skin oscillations and a higher-lying more isovector component on the tail of the giant dipole resonance.

Machine learning methods for metabolic pathway prediction

Background

A key challenge in systems biology is the reconstruction of an organism's metabolic network from its genome sequence. One strategy for addressing this problem is to predict which metabolic pathways, from a reference database of known pathways, are present in the organism, based on the annotated genome of the organism.

Results

To quantitatively validate methods for pathway prediction, we developed a large "gold standard" dataset of 5,610 pathway instances known to be present or absent in curated metabolic pathway databases for six organisms. We defined a collection of 123 pathway features, whose information content we evaluated with respect to the gold standard. Feature data were used as input to an extensive collection of machine learning (ML) methods, including naïve Bayes, decision trees, and logistic regression, together with feature selection and ensemble methods. We compared the ML methods to the previous PathoLogic algorithm for pathway prediction using the gold standard dataset. We found that ML-based prediction methods can match the performance of the PathoLogic algorithm. PathoLogic achieved an accuracy of 91% and an F-measure of 0.786. The ML-based prediction methods achieved accuracy as high as 91.2% and F-measure as high as 0.787. The ML-based methods output a probability for each predicted pathway, whereas PathoLogic does not, which provides more information to the user and facilitates filtering of predicted pathways.

Conclusions

ML methods for pathway prediction perform as well as existing methods, and have qualitative advantages in terms of extensibility, tunability, and explainability. More advanced prediction methods and/or more sophisticated input features may improve the performance of ML methods. However, pathway prediction performance appears to be limited largely by the ability to correctly match enzymes to the reactions they catalyze based on genome annotations.

Pathway Tools version 13.0: integrated software for pathway/genome informatics and systems biology

Pathway Tools is a production-quality software environment for creating a type of model-organism database called a Pathway/Genome Database (PGDB). A PGDB such as EcoCyc integrates the evolving understanding of the genes, proteins, metabolic network and regulatory network of an organism. This article provides an overview of Pathway Tools capabilities. The software performs multiple computational inferences including prediction of metabolic pathways, prediction of metabolic pathway hole fillers and prediction of operons. It enables interactive editing of PGDBs by DB curators. It supports web publishing of PGDBs, and provides a large number of query and visualization tools. The software also supports comparative analyses of PGDBs, and provides several systems biology analyses of PGDBs including reachability analysis of metabolic networks, and interactive tracing of metabolites through a metabolic network. More than 800 PGDBs have been created using Pathway Tools by scientists around the world, many of which are curated DBs for important model organisms. Those PGDBs can be exchanged using a peer-to-peer DB sharing system called the PGDB Registry.

The MetaCyc database of metabolic pathways and enzymes and the BioCyc collection of pathway/genome databases

The MetaCyc database (MetaCyc.org) is a comprehensive and freely accessible resource for metabolic pathways and enzymes from all domains of life. The pathways in MetaCyc are experimentally determined, small-molecule metabolic pathways and are curated from the primary scientific literature. With more than 1400 pathways, MetaCyc is the largest collection of metabolic pathways currently available. Pathways reactions are linked to one or more well-characterized enzymes, and both pathways and enzymes are annotated with reviews, evidence codes, and literature citations. BioCyc (BioCyc.org) is a collection of more than 500 organism-specific Pathway/Genome Databases (PGDBs). Each BioCyc PGDB contains the full genome and predicted metabolic network of one organism. The network, which is predicted by the Pathway Tools software using MetaCyc as a reference, consists of metabolites, enzymes, reactions and metabolic pathways. BioCyc PGDBs also contain additional features, such as predicted operons, transport systems, and pathway hole-fillers. The BioCyc Web site offers several tools for the analysis of the PGDBs, including Omics Viewers that enable visualization of omics datasets on two different genome-scale diagrams and tools for comparative analysis. The BioCyc PGDBs generated by SRI are offered for adoption by any party interested in curation of metabolic, regulatory, and genome-related information about an organism.

Study of antiphospholipid antibodies in type 2 diabetes mellitus with and without diabetic retinopathy

Antiphospholipid antibodies (aPL) are considered to be contributory factors in the development of thrombotic events. The objective of the study was to determine if aPL are involved in the pathogenesis of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus. IgG anticardiolipin antibodies (IgG aCL), lupus anticoagulant (LA), and anti-IgG beta2-glycoprotein I antibodies (anti-beta2-GPI) were prospectively tested in 34 patients with DR (group 1), 20 males and 14 females, range of age 52-79 years, mean age 57 +/- 4.6 years, duration of diabetes 8-15 years, as compared to 29 type 2 diabetic patients without DR (group 2), 19 males and 10 females, range of age 54-77 years, mean age 58 +/- 4.8 years, duration of diabetes 10-13 years, and to 31 controls matched for age and sex (group 3). IgG aCL and anti-beta2-GPI were detected by enzyme-linked immunosorbent assay (ELISA) and LA was detected by activated partial thromboplastin time, kaolin clotting time, dilute Russell's viper venom time, dilute prothrombin time. Comparison between patients and controls and patients group were expressed as relative risk with its 95% confidence interval (RR [95%/CI], where a lower limit > 1.0 was considered significant. All values were determined by Fischer's exact test. A value of p < 0.05 was considered statistically significant. The incidence of IgG aCL positive (low 4-15 GPL U IgG aCL titers) in group 1 was 21/34 (62%) vs. 12/29 (41%) in group 2 (RR 1.460 95% CI [0.9052 to 2.382]), p = 0.1330. The incidence of LA positive in group 1 was 27/34 (79%) vs. 8/29 (28%) in group 2 (RR 3.086 95% CI [1.584 to 6.010]), p < 0.0001. The incidence of anti-IgG beta2-GPI positive in group 1 was 29/34 (85%) vs. 6/29 (21%) in group 2 (RR 4.640 95% CI [2.067-10.418]), p < 0.0001. The results suggest the possible participation of anti-beta2-GPI and LA in the pathogenesis of DR, shifting the hemostatic balance toward a pro-thrombotic state increasing the risk of developing thrombosis.

Gamow-Teller strengths in the A = 14 multiplet: a challenge to the shell model

A new experimental approach to the famous problem of the anomalously slow Gamow-Teller (GT) transitions in the beta decay of the A=14 multiplet is presented. The GT strength distributions to excited states in 14C and 14O were studied in high-resolution (d,2He) and (3He,t) charge-exchange reactions on 14N. No-core shell-model calculations capable of reproducing the suppression of the beta decays predict a selective excitation of Jpi=2+ states. The experimental confirmation represents a validation of the assumptions about the underlying structure of the 14N ground state wave function. However, the fragmentation of the GT strength over three 2+ final states remains a fundamental issue not explained by the present no-core shell model using a 6homega model space, suggesting possibly the need to include cluster structure in these light nuclei in a consistent way.

Expectation-maximization algorithms for fuzzy assignment of genes to cellular pathways

Cellular pathways are composed of multiple reactions and interactions mediated by genes. Many of these reactions are common to multiple pathways, and each reaction might be potentially mediated by multiple genes in the same genome. Existing pathway reconstruction procedures assign a gene to all pathways in which it might catalyze a reaction, leading to a many-to-many mapping of genes to pathways. However, it is unlikely that all genes that are capable of mediating a certain reaction are involved in all the pathways that contain it. Rather, it is more likely that each gene is optimized to function in specific pathway(s). Hence, existing procedures for pathway construction produce assignments that are ambiguous. Here we present a probabilistic algorithm for the assignment of genes to pathways that addresses this problem and reduces this ambiguity. Our algorithm uses expression data, database annotations and similarity data to infer the most likely assignments, and estimate the affinity of each gene with the known cellular pathways. We apply the algorithm to metabolic pathways in Yeast and compare the results to assignments that were experimentally verified.

Gamow-teller strengths in proton-rich exotic nuclei deduced in the combined analysis of mirror transitions

Isospin symmetry is expected for the T(z)=+/-1-->0 isobaric analogous transitions in isobars with mass number A, where T(z) is the z component of isospin T. Assuming this symmetry, strengths of analogous Gamow-Teller (GT) transitions within A = 50 isobars were determined from a high energy-resolution study at 0 degrees in combination with the decay Q value and lifetime from the beta decay. This method can be applied to other pf-shell nuclei and can be used to study GT strengths of astrophysical interest.

Automation of gene assignments to metabolic pathways using high-throughput expression data

BACKGROUND

Accurate assignment of genes to pathways is essential in order to understand the functional role of genes and to map the existing pathways in a given genome. Existing algorithms predict pathways by extrapolating experimental data in one organism to other organisms for which this data is not available. However, current systems classify all genes that belong to a specific EC family to all the pathways that contain the corresponding enzymatic reaction, and thus introduce ambiguity.

RESULTS

Here we describe an algorithm for assignment of genes to cellular pathways that addresses this problem by selectively assigning specific genes to pathways. Our algorithm uses the set of experimentally elucidated metabolic pathways from MetaCyc, together with statistical models of enzyme families and expression data to assign genes to enzyme families and pathways by optimizing correlated co-expression, while minimizing conflicts due to shared assignments among pathways. Our algorithm also identifies alternative ("backup") genes and addresses the multi-domain nature of proteins. We apply our model to assign genes to pathways in the Yeast genome and compare the results for genes that were assigned experimentally. Our assignments are consistent with the experimentally verified assignments and reflect characteristic properties of cellular pathways.

CONCLUSION

We present an algorithm for automatic assignment of genes to metabolic pathways. The algorithm utilizes expression data and reduces the ambiguity that characterizes assignments that are based only on EC numbers.

Changes of the nutrient loads of the Danube since the late eighties: An analysis based on long term changes along the whole Danube River and its main tributaries

The Danube nutrient loads are affected by human impacts mainly from agriculture and wastewater discharges. Knowledge about the Danube nutrient loads and the changes of these loads over time is essential for understanding the changes within the ecosystem of the Black Sea, induced by these loads. The paper shows the long term changes of the nutrient load along the Danube estimated by measurements from different countries and institutions. The results show large differences between Dissolved Inorganic Nitrogen (DIN) and Total Phosphorus (TP). For TP, the Danube River loads show a strong decrease since 1988-1992, especially in the Middle and Lower basin. This change is probably partly connected to the dramatic economic changes in the Middle and Eastern European countries following the collapse of the communist system. The DIN load does not show a decreasing trend in the last decade. The data indicate that there may be a decreasing trend in the anthropogenic emissions, but that such a trend is counteracted by a significantly increasing trend of the Danube discharge in the last decade. The accuracy of the available data is analysed in the paper as well.

[Bilateral multifocal pulmonary leiomyomatosis]

A case of diffuse primary pulmonary leiomyomatosis with a 24-years-old asymptomatic woman having a pulmonary radiological aspect of miliary dissemination 3 years after a myomectomy for sub-serous uterine fibroma. The diagnosis was established after a surgical pulmonary biopsy. The case presented certain peculiar features: a young woman; the inter-relation between pulmonary leiomyomatosis and the operated sub-serous uterine fibroma; the aggravating factor--the pregnancy; a confirmed probably hormonal cause (hyperestrogenemia); a progressive aggravating evolution.

[Secondary active-evolutive cavitary pulmonary tuberculosis of the apicodorsal segment of the left upper lobe associated with bronchial tuberculosis and bronchial geotrichosis]

A case of active pulmonary secondary tuberculosis associated with bronchial tuberculosis and bronchial geotrichosis is presented. This association is infrequent. Favoring factors: local and general immunodepression (recurrent infection with pyogenic germs, rubella, neutropenia, aggressive antibiotherapy, iron deficiency). The diagnosis was based mainly on the bacteriological sputum examination for bK (smear and culture) and the mycologic examination (smear and culture) of the bronchial aspiration, identifying Geotrichum candidum. The treatment consisted of antituberculous and antimycotic drugs, bronchodilators, bronchial aspirations and local endoscopic administration of antimycotic drugs.

Clinical usefulness of rapid serodiagnosis in pulmonary tuberculosis by ELISA with glycolipidic antigens extracted from Mycobacterium tuberculosis and with whole BCG suspension

Antibodies against Mycobacterium tuberculosis glycolipids and whole BCG suspension were determined by ELISA on 58 sera from hospitalized patients with presumptive pulmonary tuberculosis and on 127 sera from control subjects. The experimental results demonstrated that the glycolipids are more adequate to be used as antigens than whole BCG suspension, as high sensitivity of the test was obtained. By using only one antigen, ELISA becomes more efficient in rapid diagnosis. ELISA with glycolipidic antigens should be used as a supporting test for direct smear examination in the diagnosis of pulmonary tuberculosis, especially in cases when repeated bacterial methods failed to prove the presence of M. tuberculosis.

Early re-feeding in the management of acute diarrhoea in infants of 0-1 year of age

We compared early versus late re-feeding in the management of acute diarrhoea in the first year of life. In the study group (73 groups) breast feeding was resumed or early re-feeding was performed in non-breast-fed infants, so that the feeding regimen used prior to the onset of the disease was reached within 2-3 days. In the control group (49 patients) late re-feeding was performed so that the infants returned to their original feeding pattern after 4-6 days. there were no significant differences between the two groups in the number of stools and stool output per day, or in the duration of the disease. No weight gain or loss during the diet was noted more frequently in the late re-feeding group (67.2% versus 2.3.4%). This study confirms the favourable effect on body weight of early re-feeding in the management of acute diarrhoea.

[Our experience in the conservative surgical treatment of coxarthrosis]

The authors present the substantiation of the use of conservative treatment in a series of 163 patients with coxarthrosis operated upon between 1983 and 1990. In 135 of these patients various types of osteotomies were performed: Pauwels valgisation or varus femoral osteotomy (42 cases), McMurray displacement osteotomy (41 cases), varus and displacement osteotomy (19 cases) and Chiari pelvic osteotomy (33 cases). In the remainder of 28 patients tenotomies and hip denervations were performed. The postoperative results, estimated by a strict clinico-radiological survey revealed a marked clinical improvement and radiographically a restoration of joint congruence in about 80% of the cases.

In vitro effects of pulsed near-ultraviolet laser exposure on human larynx carcinoma cells

Effects of pulsed near-ultraviolet laser beam on structural characteristics and macromolecular synthesis of carcinoma HEp2 cells were investigated. Laser irradiation damage induced in these eukaryotic cells could be characterized by two development stages: a) a reversible stage with minor morphological damages (1.5 kJ/m2) and 2) an irreversible one, at higher fluences, characterized by cellular membrane damage, necrobiosis and cells detachment from the substrate (4.5 kJ/m2). A. Studies performed referring to macromolecular syntheses of low laser fluences (1.5 kJ/m2)--irradiated HEp2 cells showed the following aspects: a) syntheses inhibiton phase in the first cycles of cellular replication and b) syntheses stimulation phases in the following cycle with total repair of laser-induced molecular lesions. B. At high laser fluences (3-4.5 kJ/m2), metabolic lesions repair was partially or totally blocked after prolonged culturing at 37 degrees C. Ths paper suggests some mechanisms of laser action on macromolecular synthesis and correlates them with morphological changes induced by laser exposure of carcinoma cells.

[The Rubinstein-Taybi syndrome]

The paper reports on the case of an infant, diagnosed at 4 months, with Rubinstein-Taybi's syndrome. The main clinical manifestations of the syndrome, that allowed the case diagnosis, are presented. A series of succinct data on the syndrome and also the pathogenic hypotheses are reviewed.

The continuous decrease in the number of SSPE annual cases ten years after compulsory anti-measles immunization

The record of SSPE cases diagnosed immunochemically and serologically in our laboratory, standing for about 60% of the total new cases reported in our country, shows a significant decrease in the incidence in 1988-89 (from 5.21 new cases per year per million total population in 1987 to 1.82 cases in 1988). In 85% of the patients, SSPE onset occurred at the age of 10 years or more, suggesting the possibility of a primary measles infection before anti-measles immunization became compulsory. High serum and CSF anti-measles antibody titres in recently diagnosed patients show subclinical long-term courses. Further serologic tests for viruses inducing persistent infections (herpes viruses, AgHBs and HIV) do not show any difference when compared to a control group excepting an increased incidence of anti-cytomegalic titres.

[The mechanisms of persistent measles virus infection in HEp-2 cells]

Persistent infection with Edmonston strain of measles virus was established in a highly susceptible clone of HEp-2 cells. The morphological and cytogenic aspects of persistent infection are presented. Carriage of measles virus in cells persistently infected is marked by important differences between standard Edmonston strain and virus stocks isolated from time to time from the carrier state. It is especially significant that cell fusion capacity decreased in amount concordant with the drop in the yield of infectious virus. Addition of UV inactivated Sendai virus, trypsin treatment or incubation at suboptimal temperatures precipitate the cytocidal effect of measles virus. Some clinical implications of reactivation of the lytic cycle in the carrier state are suggested.

[Heart conduction disorders in pediatric practice]

This study was prepared on the basis of the recent data published in the specialized literature, as well as on the personal experience of the authors, and is considered as a necessary updating in the field of heart rhythm disturbances which occur in the child. A review is presented of sinoatrial blocks, of atrioventricular conduction disturbances, and of intraventricular conduction abnormalities (branch blocks). A modern classification is used in the discussion of sinoatrial, and of atrioventricular blocks, with the three distinctive degrees (first degree block, second degree block--with type I and type II variants, and the third degree block). The authors have attempted, in their effort to present the data concerning each of the entities, to include a series of anatomical and electrophysiological notions, some of which represent modern acquisitions obtained by endocavitary electrocardiographic exploration, and which are considered to be essential for a good understanding of the material. An important place is given--for each of the entities discussed--to the etiological study, as well as to clinical semiology, and electrocardiography, to problems related to the positive and differential diagnosis, and to therapeutical means, as well as to evolution and prognosis. The study is concluded by a presentation of intraventricular conduction disturbances (branch blocks) which are evaluated in their distinct variants: the monofascicular block (single bundle block), the bi- and trifascicular bundle blocks, major or minor blocks, and functional rate-dependent blocks. In these cases also the authors have analysed etiologic aspects, the clinical picture, and the electrocardiographic aspects, as well as therapeutical, evolutive and prognostic features for each of the different forms.

S.S.P.E.: some clues to pathogenesis from epidemiological data

This study is a preliminary report of the national registry of S.S.P.E. cases started in 1987 which continue early epidemiological inquiries concerning incidence in Romania during the decade 1978-1987. The analysis pointed out the high incidence of this disease: a mean incidence rate of 6.35 cases per year per million total population in the last three years. Since 1979 there has been in Romania a sharp decline in the incidence of measles induced by the initiation of compulsory vaccination. As yet this decline is not reflected in S.S.P.E. incidence. The male/female ratio varied between 1.78-3.3 according to the year of observation. The mean age at S.S.P.E. onset increased from 6-7 years at the beginning of the interval to 9.63 years in 1987. The S.S.P.E. incidence is unevenly distributed between rural and urban area and clusters of S.S.P.E. cases were observed in certain countries. Other categories of information which may be relevant to pathogenesis are discussed: immunological history, previous hospitalization and illnesses, family history, recent health problems prior to S.S.P.E. onset, education, vacations, food habits and animal-exposure history.

Antiviral effect of lithium chloride

Studies in human embryo fibroblasts infected with measles or herpes simplex virus showed a reduction in virus yield when cultures were pretreated with 1-10 mM lithium chloride doses. Maximum effect was obtained by a 1 h treatment with 10 mM lithium chloride, preceding viral infection by 19-24 hours. A specific antiviral effect against measles virus was manifest immediately after culture pretreatment. Intermittent treatment with 10 mM lithium chloride of cultures persistently infected with measles or herpes virus obtained from human myeloid K-562 cell line shows a reduction in the extracellular virus yield. In the K-562/herpes virus system, the culture treatment with lithium chloride and acyclovir (10 microM) has an additive inhibitory effect on virus production. The paper is focused on the mechanism of lithium chloride antiviral action and the expediency of lithium therapy in SSPE (subacute sclerosing panencephalitis).

Immunochemical aspects of cerebrospinal fluid immunoglobulins in patients with subacute sclerosing panencephalitis

Unconcentrated cerebrospinal fluid (CSF) samples from 50 patients with subacute sclerosing panencephalitis (SSPE) were investigated by rocket immunoelectrophoresis (RIE) against anti-human IgG sera. Two patterns of immune precipitates were observed: precipitates with exclusively cathodal and precipitates with bipolar extension. Hemagglutination-inhibition tests against measles virus antigen were performed after absorption of the CSF samples with Protein A-containing Staphylococcus aureus and treatment with 2-mercaptoethanol. The results point to different pathological significances of the precipitation line anomalies revealed by RIE, that might be relevant for some of the patients investigated.

Further data on the antigenic drift in subacute sclerosing panencephalitis (SSPE)

Serum and cerebrospinal fluid samples from 43 SSPE patients were investigated by double radial immunodiffusion against a measles virus cell pack antigen. The pattern of immune precipitates suggested that antigenic drift may be involved in the pathogeny of persistent virus infection.