The lymphatic filariasis treatment study landscape: A systematic review of study characteristics and the case for an individual participant data platform

BACKGROUND

Lymphatic filariasis (LF) is a neglected tropical disease (NTD) targeted by the World Health Organization for elimination as a public health problem (EPHP). Since 2000, more than 9 billion treatments of antifilarial medicines have been distributed through mass drug administration (MDA) programmes in 72 endemic countries and 17 countries have reached EPHP. Yet in 2021, nearly 900 million people still required MDA with combinations of albendazole, diethylcarbamazine and/or ivermectin. Despite the reliance on these drugs, there remain gaps in understanding of variation in responses to treatment. As demonstrated for other infectious diseases, some urgent questions could be addressed by conducting individual participant data (IPD) meta-analyses. Here, we present the results of a systematic literature review to estimate the abundance of IPD on pre- and post-intervention indicators of infection and/or morbidity and assess the feasibility of building a global data repository.

METHODOLOGY

We searched literature published between 1st January 2000 and 5th May 2023 in 15 databases to identify prospective studies assessing LF treatment and/or morbidity management and disease prevention (MMDP) approaches. We considered only studies where individual participants were diagnosed with LF infection or disease and were followed up on at least one occasion after receiving an intervention/treatment.

PRINCIPAL FINDINGS

We identified 138 eligible studies from 23 countries, having followed up an estimated 29,842 participants after intervention. We estimate 14,800 (49.6%) IPD on pre- and post-intervention infection indicators including microfilaraemia, circulating filarial antigen and/or ultrasound indicators measured before and after intervention using 8 drugs administered in various combinations. We identified 33 studies on MMDP, estimating 6,102 (20.4%) IPD on pre- and post-intervention clinical morbidity indicators only. A further 8,940 IPD cover a mixture of infection and morbidity outcomes measured with other diagnostics, from participants followed for adverse event outcomes only or recruited after initial intervention.

CONCLUSIONS

The LF treatment study landscape is heterogeneous, but the abundance of studies and related IPD suggest that establishing a global data repository to facilitate IPD meta-analyses would be feasible and useful to address unresolved questions on variation in treatment outcomes across geographies, demographics and in underrepresented groups. New studies using more standardized approaches should be initiated to address the scarcity and inconsistency of data on morbidity management.

Infectious diseases data observatory (IDDO) visceral leishmaniasis library of clinical therapeutic studies: A protocol for a living systematic review of clinical studies

Introduction: Visceral leishmaniasis (VL) is a vector-borne disease caused by protozoan parasites of the genus Leishmania. The disease is endemic in parts of South Asia, East Africa, South America and the Mediterranean region, with an estimated 50,000 to 90,000 cases occurring annually. A living systematic review of existing scientific literature is proposed to identify clinical drug efficacy studies against VL, conducted following the Preferred Reporting Items for Systematic-Reviews and Meta-Analyses (PRISMA) guidelines. Methods and analysis: The proposed living systematic review builds on a previous systematic review first carried out in 2016, and the current protocol is designed to capture any published or registered VL clinical study from Nov-2021 onwards. The following databases will be searched by a medical librarian: PubMed, Ovid Embase, Scopus, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, WHO ICTRP, as well as IMEMR, IMSEAR, and LILACS from the WHO Global Index Medicus. The systematic review will consider both randomised and non-randomised interventional studies, including single-armed studies. Ethics and dissemination: A database of eligible studies, including study characteristics, is openly available (https://www.iddo.org/tool/vl-surveyor) and will be continually updated every six months. All findings will be published in a peer-reviewed journal. PROSPERO registration: CRD42021284622 (29/11/2021)

The fragmented COVID-19 therapeutics research landscape: a living systematic review of clinical trial registrations evaluating priority pharmacological interventions

Background: Many available medicines have been evaluated as potential repurposed treatments for coronavirus disease 2019 (COVID-19). We summarise the registered study landscape for 32 priority pharmacological treatments identified following consultation with external experts of the COVID-19 Clinical Research Coalition. Methods: All eligible trial registry records identified by systematic searches of the World Health Organisation International Clinical Trials Registry Platform as of 26th May 2021 were reviewed and extracted. A descriptive summary of study characteristics was performed. Results: We identified 1,314 registered studies that included at least one of the 32 priority pharmacological interventions. The majority (1,043, 79%) were randomised controlled trials (RCTs). The sample size of the RCTs identified was typically small (median (25th, 75th percentile) sample size = 140 patients (70, 383)), i.e. individually powered only to show very large effects. The most extensively evaluated medicine was hydroxychloroquine (418 registered studies). Other widely studied interventions were convalescent plasma (n=208), ritonavir (n=189) usually combined with lopinavir (n=181), and azithromycin (n=147). Very few RCTs planned to recruit participants in low-income countries (n=14; 1.3%). A minority of studies (348, 26%) indicated a willingness to share individual participant data. The living systematic review data are available at https://iddo.cognitive.city Conclusions: There are many registered studies planning to evaluate available medicines as potential repurposed treatments of COVID-19. Most of these planned studies are small, and therefore substantially underpowered for most relevant endpoints. Very few are large enough to have any chance of providing enough convincing evidence to change policies and practices. The sharing of individual participant data (IPD) from these studies would allow pooled IPD meta-analyses which could generate definitive conclusions, but most registered studies did not indicate that they were willing to share their data.

Improving anthelmintic treatment for schistosomiasis and soil-transmitted helminthiases through sharing and reuse of individual participant data

The Infectious Diseases Data Observatory (IDDO, https://www.iddo.org) has launched a clinical data platform for the collation, curation, standardisation and reuse of individual participant data (IPD) on treatments for two of the most globally important neglected tropical diseases (NTDs), schistosomiasis (SCH) and soil-transmitted helminthiases (STHs). This initiative aims to harness the power of data-sharing by facilitating collaborative joint analyses of pooled datasets to generate robust evidence on the efficacy and safety of anthelminthic treatment regimens. A crucial component of this endeavour has been the development of a Research Agenda to promote engagement with the SCH and STH research and disease control communities by highlighting key questions that could be tackled using data shared through the IDDO platform. Here, we give a contextual overview of the priority research themes articulated in the Research Agenda-a 'living' document hosted on the IDDO website-and describe the three-stage consultation process behind its development. We also discuss the sustainability and future directions of the platform, emphasising throughout the power and promise of ethical and equitable sharing and reuse of clinical data to support the elimination of NTDs.

1232 Trust-Wide Assessment of Delirium in Post-Operative Elective Surgery

Aim

Delirium is an acute change in cognition and associated with adverse patient outcomes. The incidence of post-operative delirium after elective non-cardiac surgery is unknown. We aimed to assess the incidence of post-operative delirium in this group and the effect on patient outcomes.

Method

Patients aged 65 and over who underwent elective non-cardiac surgery were identified on post-operative day three. Delirium screening was performed in real time using the validated 4-AT assessment tool. A retrospective review of the patients’ preoperative and perioperative record was conducted to collect demographics and identify risk factors for delirium. Outcome data was collected at 30 days. Patients with a positive delirium score (>4) underwent a more in-depth assessment and managing teams given a delirium management pack.

Results

75 (39 male) consecutive patients were screened over a period of 4 months. Median age 77 years and 18% had frailty assessed as “vulnerable”. The majority of patients (37.3%) underwent thoracic surgery, followed by hepatobiliary (17.3%), gynaecological (17.3%), colorectal (12%), maxillofacial (9.3%) and ENT (4%). 5.3% (4) of patients had a positive 4-AT screen. No patients had a formal delirium screen or diagnosis in the initial 48 hours. The median length of stay for patients with a positive screen was 8.5 days (IQR 7.5-12) compared to 8 days (IQR 5-13) for patients with a negative screen.

Conclusions

Reassuringly, rate of post-operative delirium following elective operations in our Trust are low (5%). Larger numbers of patients are required to assess the impact this has on patient outcomes and identify correlation with risk factors.

Baseline results of a living systematic review for COVID-19 clinical trial registrations

Background: Since the coronavirus disease 2019 (COVID-19) outbreak was first reported in December 2019, many independent trials have been planned that aim to answer similar questions. Tools allowing researchers to review studies already underway can facilitate collaboration, cooperation and harmonisation. The Infectious Diseases Data Observatory (IDDO) has undertaken a living systematic review (LSR) to provide an open, accessible and frequently updated resource summarising characteristics of COVID-19 study registrations. Methods: Review of all eligible trial records identified by systematic searches as of 3 April 2020 and initial synthesis of clinical study characteristics were conducted. In partnership with Exaptive, an open access, cloud-based knowledge graph has been created using the results.  Results: There were 728 study registrations which met eligibility criteria and were still active. Median (25 th, 75 th percentile) sample size was 130 (60, 400) for all studies and 134 (70, 300) for RCTs. Eight lower middle and low income countries were represented among the planned recruitment sites. Overall 109 pharmacological interventions or advanced therapy medicinal products covering 23 drug categories were studied. Majority (57%, 62/109) of them were planned only in one study arm, either alone or in combination with other interventions. There were 49 distinct combinations studied with 90% (44/49) of them administered in only one or two study arms. The data and interactive platform are available at https://iddo.cognitive.city/. Conclusions:  Baseline review highlighted that the majority of investigations in the first three months of the outbreak were small studies with unique treatment arms, likely to be unpowered to provide solid evidence.  The continued work of this LSR will allow a more dependable overview of interventions tested, predict the likely strength of evidence generated, allow fast and informative filtering of relevant trials for specific user groups and provide the rapid guidance needed by investigators and funders to avoid duplication of efforts.

The Department of Pathology at the German Primate Center from 1973 to 1999

Abstract. The Department of Pathology was the first scientific unit established at the German Primate Center (DPZ) already in its planning phase. At that early time the planning of administrative duties was also necessary, including the financial framework of the laboratory equipment of the then-envisioned three departments of pathology, virology and physiology, in order to get the DPZ off the ground. Otherwise the functions of the Department of Pathology were both service duties and scientific evaluations. The service functions after the establishment of the DPZ included pathological, bacteriological and parasitological examinations/surveys and the veterinary care of nonhuman primates at the DPZ and other primate colonies. On an international level its service functions were reflected by the collaboration within the Office International de Epizooties (OIE, Paris) (Dollinger et al., 1996) and the Infectious Diseases Working Group of the European Association of Zoo and Wildlife Veterinarians, and the establishment of a bacteriological laboratory in Iquitos, Peru, at the request of the Pan American Health Organization. Parallel to those administrative and service duties to the DPZ and to international communities, the different scientific activities started, which in a pathology department always are a combination of service and research. They are documented by a total of almost 120 publications, including 3 doctoral theses and 116 publications by the author from 1973 to 1999; the most important ones are summarized in the following examples.

Semiclassical theory for spatial density oscillations in fermionic systems

We investigate the particle and kinetic-energy densities for a system of N fermions bound in a local (mean-field) potential V(r) . We generalize a recently developed semiclassical theory [J. Roccia and M. Brack, Phys. Rev. Lett. 100, 200408 (2008)] in which the densities are calculated in terms of the closed orbits of the corresponding classical system to D>1 dimensions. We regularize the semiclassical results (i) for the U(1) symmetry breaking occurring for spherical systems at r=0 and (ii) near the classical turning points where the Friedel oscillations are predominant and well reproduced by the shortest orbit going from r to the closest turning point and back. For systems with spherical symmetry, we show that there exist two types of oscillations which can be attributed to radial and nonradial orbits, respectively. The semiclassical theory is tested against exact quantum-mechanical calculations for a variety of model potentials. We find a very good overall numerical agreement between semiclassical and exact numerical densities even for moderate particle numbers N . Using a "local virial theorem," shown to be valid (except for a small region around the classical turning points) for arbitrary local potentials, we can prove that the Thomas-Fermi functional tau(TF)[rho] reproduces the oscillations in the quantum-mechanical densities to first order in the oscillating parts.

Periodic orbit theory for the Hénon-Heiles system in the continuum region

We investigate the resonance spectrum of the Hénon-Heiles potential up to twice the barrier energy. The quantum spectrum is obtained by the method of complex coordinate rotation. We use periodic orbit theory to approximate the oscillating part of the resonance spectrum semiclassically and Strutinsky smoothing to obtain its smooth part. Although the system in this energy range is almost chaotic, it still contains stable periodic orbits. Using Gutzwiller's trace formula, complemented by a uniform approximation for a co-dimension-two bifurcation scenario, we are able to reproduce the coarse-grained quantum-mechanical density of states very accurately, including only a few stable and unstable orbits.

Semiclassical trace formulas for pitchfork bifurcation sequences

In nonintegrable Hamiltonian systems with mixed phase space and discrete symmetries, sequences of pitchfork bifurcations of periodic orbits pave the way from integrability to chaos. In extending the semiclassical trace formula for the spectral density, we develop a uniform approximation for the combined contribution of pitchfork bifurcation pairs. For a two-dimensional double-well potential and the familiar Hénon-Heiles potential, we obtain very good agreement with exact quantum-mechanical calculations. We also consider the integrable limit of the scenario which corresponds to the bifurcation of a torus from an isolated periodic orbit. For the separable version of the Hénon-Heiles system we give an analytical uniform trace formula, which also yields the correct harmonic-oscillator SU(2) limit at low energies, and obtain excellent agreement with the slightly coarse-grained quantum-mechanical density of states.

Semiclassical theory of spin-orbit interactions using spin coherent states

We formulate a semiclassical theory for systems with spin-orbit interactions. Using spin coherent states, we start from the path integral in an extended phase space, formulate the classical dynamics of the coupled orbital and spin degrees of freedom, and calculate the ingredients of Gutzwiller's trace formula for the density of states. For a two-dimensional quantum dot with a spin-orbit interaction of Rashba type, we obtain satisfactory agreement with fully quantum-mechanical calculations. The mode-conversion problem, which arose in an earlier semiclassical approach, has hereby been overcome.

Three spontaneous lymphomas in a colony of cotton-top tamarins (Saguinus oedipus)

Cotton-top tamarins are well known for their prevalence to idiopathic colitis and adenocarcinomas. At the same time, information on the incidence of spontaneous lymphomas in this highly endangered species is rare. Records, 212 in total, of cotton-top tamarins (Saguinus oedipus) necropsied at the German Primate Centre between 1979 and 1998 were viewed to establish the prevalence of lymphoid neoplasms. Neoplastic lymphoid cell growth was mentioned in three necropsy records. Immunohistology was performed in all three cases on the remaining formalin-fixed, paraffin-embedded tissue using antibodies against CD20, CD3, lysozyme, Ki-67, IgM, IgG, kappa, lambda and EBNA-2. Combining histological and immunohistological results, the lymphomas could be differentiated into two low-grade T-cell lymphomas and one high-grade multicentric polymorphic B-cell lymphoma. This corresponds to a 1.4% incidence of lymphomas in our cotton-top tamarin population over a period of 19 years. Although frozen material was not available and virological testing could not be carried out, clinical or histological evidence did not support an aetiological role of Herpes (H.) saimiri, H. ateles, simian T-cell leukaemia virus type 1 (STLV-1) or Epstein-Barr-related herpesvirus in any of these cases. The lymphomas were considered to be spontaneous.

Periodic-orbit bifurcations and superdeformed shell structure

We have derived a semiclassical trace formula for the level density of the three-dimensional spheroidal cavity. To overcome the divergences occurring at bifurcations and in the spherical limit, the trace integrals over the action-angle variables were performed using an improved stationary phase method. The resulting semiclassical level density oscillations and shell-correction energies are in good agreement with quantum-mechanical results. We find that the bifurcations of some dominant short periodic orbits lead to an enhancement of the shell structure for "superdeformed" shapes related to those known from atomic nuclei.

Unusual presentation of a primary spinal Burkitt's lymphoma

Primary CNS lymphomas are detected with increasing frequency in immunocompetent and immunodeficient persons. Primary involvement of the spinal roots has only rarely been reported. The unusual history is described of a patient with a primary spinal Burkitt's lymphoma initially presenting as an S1 syndrome showing lymphocytic pleocytosis in the CSF, leading to the misdiagnosis of meningoradiculitis. Repeated spinal MRI disclosed a spinal mass lesion and histological and immunohistological examination of the tumour confirmed the diagnosis of spinal Burkitt's lymphoma.

Simple analytical particle and kinetic energy densities for a dilute fermionic gas in a d-dimensional harmonic trap

We derive simple analytical expressions for the particle density rho(r) and the kinetic energy density tau(r) for a system of noninteracting fermions in a d-dimensional isotropic harmonic oscillator potential. We test the Thomas-Fermi (TF, or local-density) approximation for the functional relation tau[rho] using the exact rho(r) and show that it locally reproduces the exact kinetic energy density tau(r), including the shell oscillations, surprisingly well everywhere except near the classical turning point. For the special case of two dimensions (2D), we obtain the unexpected analytical result that the integral of tau(TF)[rho(r)] yields the exact total kinetic energy.

Incidence of testicular lesions in a population of tree shrews (Tupaia belangeri)

BACKGROUND AND PURPOSE

The sexual activity of male tree shrews is socially influenced; therefore, the testicular lesions in adult male tree shrews were of interest.

METHODS

The testes of 229 adult and 9 subadult male tree shrews were obtained during routine necropsy and were subjected to light microscopy. At one time, 138 animals were experimentally exposed to social conflicts.

RESULTS

Hypospermatogenesis (testicular inactivity) was observed in social stress-exposed males up to two years of age. Seasonality of hypospermatogenesis could not be statistically supported. Testicular atrophy, observed in 21 animals, was neither stress- nor age-related; it developed unilaterally, with the left testis preferred. Testicular tumors developed in animals older than 2 years, with increasing frequency particularly of Leydig cell tumors in animals more than four year old.

CONCLUSION

Testicular lesions were more frequently found in male tree shrews than they were observed in nonhuman primates kept at the German Primate Center. Connections to social stress were statistically supported, particularly with respect to hypospermatogenesis. Testicular tumors, in contrast, were distinctly age related.

Adrenal gland tumours in two cotton-top tamarins (Saguinus oedipus oedipus)

Two adrenal gland tumours in captive born cotton-top tamarins (Saguinus oedipus oedipus) are described. One was a pheochromocytoma in a 14-year-old male, the other one a cortical adenoma in a 7.5-year-old female. Both were associated with morphological signs of myocardial damage and circulatory problems. The findings are discussed and compared to adrenal gland tumours in man.

IgM/IgA nephropathy in callitrichids: antigen studies

Renal tissues of callitrichids with IgM nephropathy were immunohistochemically examined for the participation of IgA in pathogenesis. In 58 histopathologically nephropathy-positive kidneys, IgM predominated in 20 cases and IgA in 7 cases, and in 31 cases both immunoglobulins were rated to be approximately equally involved. The disease, therefore, might be described as IgM/IgA nephropathy. The renal tissues and sera were also tested for nutritional antigens or antinutritional antigen antibodies, using immunohistochemistry and Western blots (tissues) and enzyme-linked immunosorbent assay (sera). Evidences of nutritional antigens in the renal tissues were inconclusive, although circulating IgG class antibodies against cereals, milk, and egg proteins were present in quite a number of sera. Particular consideration was paid to IgA-antigliadin antibodies, which were statistically significantly associated with nephropathy as were IgA rheumatoid factors. The findings are discussed in relation to human IgA and IgM nephropathies.

GAG deletion in the DYT1 gene in early limb-onset idiopathic torsion dystonia in Germany

We examined 57 patients with idiopathic torsion dystonia (ITD) for the 3-bp GAG deletion in the DYT1 gene on human chromosome 9q34. Three of five patients with early limb-onset ITD, one of them with a positive family history, tested positive for the mutation, as did one young patient with multifocal dystonia and a short course of the disease. Two patients with early-onset generalized dystonia beginning in the cervical muscles, as well as five other patients with multifocal, 14 patients with segmental, and 30 patients with focal cervical dystonia did not carry the mutation. This suggests that the GAG deletion is responsible for a major portion of cases of typical early limb-onset dystonia, but not for other types of dystonia, in our population.

Gastrointestinal tumors observed in nonhuman primates at the German primate center

Twenty-six gastrointestinal tumors were observed in twenty-three nonhuman primates during routine necropsies at the German Primate Center, Göttingen. The majority (15 cases) were colorectal mucoid adenocarcinomas in cotton-top tamarins (Saguinus oedipus), which in two animals were associated with gastric adenomas. Three cases of small intestinal mucoid adenocarcinomas occurred in common marmosets (Callithrix jacchus). One colonic leiomyoma was observed in a dwarf galago (Galagoides demidovii) and another one in a cotton top tamarin. Singular findings were a tubular adeno-carcinoma of the ileo-caecal valve in a saddle-backed tamarin (Saguinus fuscicollis) and a lymphosarcoma of jejunum, ileum, and colon in another saddle-backed tamarin. Multiple tubular adeno-carcinomas of the colonic diverticles occurred in an aged rhesus monkey (Macaca mulatta). The findings are discussed in comparison to the situation in man.

Adrenal cortical epithelial cysts in two saddleback tamarins (Saguinus fuscicollis)

Adrenal cysts of epithelial origin were found incidentally in the adrenal cortical tissues of two adult female saddleback tamarins. In one case, a small cluster of minor cysts was located at the cortico-medullary border. The cysts were filled with a periodic acid-Schiff (PAS)-positive, amorphous substance and lined by a cuboidal PAS-negative epithelium, which resembled morphologically the ascending Henle's loops of the kidney. These microcysts were thought to be mesonephric remnants. In the second case, two large cysts of 1 to 3 mm diameter extended throughout the entire cortex. The cysts were filled by a watery, PAS-negative fluid and lined by a bi- to multi-layered, cytokeratin-positive epithelium. The basal epithelial layer consisted of cuboidal cells, which became cylindrical to drop-like in appearance towards the cyst lumen. The cysts closely resembled mesothelium-derived adrenal cysts in man. This is the first report of adrenal cysts in non-human primates.

Spontaneous tumours in tree shrews (Tupaia belangeri): population studies

In a necropsy series at the German Primate Centre, 63 of 1132 tree shrews were found to have tumours. The youngest affected animal was < 6 months old, but the incidence of tumours increased strikingly beyond 2 years of age; of 17 animals aged > 8 years, no less than 14 (82.4%) were affected. The sites of neoplasia were the genital system (22 cases), haematopoietic system (18 cases of malignant lymphoma, many involving the digestive tract), lungs (14 cases), integument (five cases), digestive tract (three cases other than those with malignant lymphoma) and urinary bladder (one case).

Brain potentials reveal the timing of face identity and expression judgments

Event-related brain potentials (ERPs) were recorded from multiple scalp locations from young human subjects while they performed two different face processing tasks. The first task entailed the presentation of pairs of faces in which the second face was either a different view of the first face or a different view of a different face. The subjects had to decide whether or not the two faces depicted the same person. In the second task, pairs of faces (frontal views) were presented with the task of judging whether the expression of the second face matched that of the face. Incongruous faces in the view (identity) matching task gave rise to a negativity peaking at about 350 ms with a frontocentral maximum. This effect was similar to the N400 obtained in linguistic tasks. ERP effects in the expression matching task were much later and had a different distribution. This pattern of results corresponds well with neuropsychological and neuroimaging data suggesting specialized neuronal populations subserving identity and expression analysis but adds a temporal dimension to previous investigations.

An outbreak of Streptococcus equi ssp. zooepidemicus infection of probable human origin in Wanderoos (Macaca silenus)--case report

Three out of ten young to adult wanderoos (M. silenus) of a breeding colony at the Rheine Zoo died within two days from a peracute illness, characterized by salivation, vomiting, apathy and minor CNS symptoms. Streptococcus equi ssp. zooepidemicus was isolated in pure cultures from all organs of two animals investigated bacteriologically. The strains were penicillin-susceptible, and penicillin treatment of all remaining animals cured two already sick animals and prevented further cases. A volunteer worker with upper respiratory disease was suspected as source of infection; contact with equine materials and rodents could be excluded.

Suspected dermatophilosis in an adult orangutan (Pongo pygmaeus pygmaeus)

An adult female Bornean orangutan (Pongo pygmaeus pygmaeus) had a pruritic, vesicular skin disease, particularly of the extremities, trunk, and face. Over a 2-yr course, symptoms resolved only transiently after corticosteroid treatment. Antibiotic treatment and withdrawal of all corticosteroids resulted in complete recovery of the animal and return to normal activity patterns. On the basis of the dermal histopathologic lesions, Dermatophilus congolensis was suspected as the causative organism, although subsequent cultivation was not attempted because of the stress additional procedures would have caused to the orangutan.

Alveolar hydatidosis (Echinococcus multilocularis) in a captive rhesus monkey (Macaca mulatta) in Germany

A naturally occurring E. multilocularis infection in an 11-year-old female rhesus monkey is described. The infection most probably was acquired from foxes of the Göttingen area through contaminated branches or foliage taken from the nearby forest. The most severely affected organs were the liver and the lung, A limited serological survey using the Em2plus ELISA revealed 5 more animals which so far remain clinically healthy as possibly infected.

Event-related brain potentials to unfamiliar faces in explicit and implicit memory tasks

The purpose of this study was to investigate electrophysiological correlates related to the recognition of repeated faces in the intact human by means of event-related brain potentials (ERPs). A group of young healthy adults performed a continuous face recognition task, in which 240 unfamiliar faces were flashed upon a computer screen with 80 of the faces being repetitions. The subjects had to classify faces as previously seen and previously unseen faces. The concomitantly recorded ERPs from 19 scalp sites revealed a more positive going waveform for the correctly classified repeated faces beginning at about 280 ms (old/new effect). The same subjects performed a similar task with visually presented concrete nouns as stimuli. The old/new effect in this task showed a similar distribution, amplitude and onset latency. It is thus concluded that the old/new effect is not specific to the materials to be memorized. In contrast, the old/new effect in an implicit face repetition experiment (with the detection of famous persons being the task) showed a different distribution. It is argued that the differential distribution might reflect the different requirements of the two tasks (explicit vs. implicit task). Recent interpretations of the old/new effects are discussed.

Eikenella corrodens-caused botryomycosis-type pneumonia in a barbary ape (Macaca sylvanus)

An 18-year-old female barbary ape in a safari park died from a mixed bacterial infection. Staphylococus aureus was isolated from a purulent necrotic mastitis and from a chronic purulent granulomatous sialoadenitis of the sublingual glands, Eikenella corrodens from a botryomycosis-type pneumonia. As judged by histopathology, mixed infection of S. aureus and E. corrodens was present in the sialoadenitis, and E. corrodens botryomycosis-type bacterial colonies were also present in the pancreatic parenchyma, though here no bacteriological isolation was attempted. A generalized amyloidosis, and especially pancreatic islet amyloidosis, probably indicated an altered immunological competence.

Pulmonary histiocytosis in tree shrews (Tupaia belangeri)

Granulomatous lesions similar to those of pulmonary histiocytosis in rats developed spontaneously in the lungs of captive tree shrews. Incidence peaked in 3-year-old tree shrews. Sex dependency was not observed, and development of the granulomas was unrelated to experimental procedures because the lesions were observed in animals from the breeding stock as well. The granulomas consisted of amorphous material, foam cells, and a few foreign body-type multinuclear giant cells; they also contained acicular clefts, often with some fibrous material. Alveolar septa within and adjacent to the granulomas were thickened in most instances, but did not contain inflammatory cells in appreciable numbers or amyloid. Only traces of cholesterol and calcium were detected in the amorphous material; neutral fat was stored in the foam cells and the amorphous masses. Fibers without birefringency were documented by polarization and scanning electron microscopy in the vicinity of granulomas, which in energy-dispersive X-ray microanalysis consisted mostly of calcium, but lacked silicon.

Tumors of the respiratory tract observed at the German Primate Center, 1978-1994

Eight spontaneous pulmonary tumors (four bronchiolar tubular adenomas, two bronchiolar adenocarcinomas, two squamous-cell carcinomas) occurred in a total of 54 adult tree shrews (Tupaia belangeri) of the GPC colonies between 1978 and 1994. The adenomas and adenocarcinomas consisted of tubularly or trabecularly arranged cuboidal to cylindrical cells interspersed with some PAS-positive goblet cells, thus resembling the epithelial lining of respiratory bronchioles of tree shrews. The two squamous-cell carcinomas probably originated from the pulmonary alveoles. Three more pulmonary tumors (one small-cell carcinoma, one bronchial adenoma, one squamous-cell carcinoma) developed in 409 adult callitrichids of the GPC colonies during the same period, and one more bronchial adenoma was observed in a common marmoset (Callithrix jacchus) of another colony located in Göttingen. With regard to the adenomas and squamous-cell carcinomas, a similar cellular origin with the three shrews is assumed. The small-cell carcinoma possibly developed from the bronchial epithelium, provided a pathogenesis parallel to that of human small-cell carcinoma is suggested. Four of the tree shrew pulmonary adenomas/adenocarcinomas and the small-cell Ca were macroscopically visible as yellowish-grey nodules of 1 mm x 1 mm to 15 mm x 15 mm diameter, predominantly involving the main lobes (2 x right main lobes, 2 x left main lobes, 1 x all lobes). The pulmonary tumors of the other animals were below macroscopical detectability.

Apolipoprotein E polymorphism does not predict risk of restenosis after coronary angioplasty

A recent report has suggested that the E4 allele of apolipoprotein (apo) E increases the risk of restenosis after percutaneous transluminal coronary angioplasty (PTCA) and also that it interacts synergistically with the deletion (D) allele of the angiotensin-converting enzyme (ACE) to increase the risk sixteen-fold. To investigate this further, we genotyped 231 subjects with successful PTCA who underwent planned repeat angiography at 4 months to assess the degree of restenosis. Subjects carrying the apo E4 allele (n = 71) were well matched with non-carriers (n = 160) for clinical and pre- and post-PTCA angiographic features. We found no increase in either apo E4 allele frequency (18.4% versus 15.6%, P = 0.42) or apo E4 homozygosity (2/106 versus 5/125, P = 0.30) in those with restenosis compared with those without. The relative risk of restenosis for apo E4 carriers was 1.11 (95% CI = 0.87-1.42). In apo E4 carriers, restenosis frequency was similar in those also carrying the ACE D allele and those without (28/55 (50.9%) versus 9/16 (56.2%), P = 0.71) and there was no significant increase in restenosis risk in carriers of both the apo E4 and ACE D alleles compared to the rest (odds ratio 1.30, 95% CI 0.68-2.50, P = 0.39). We conclude that in our cohort, the apo E4 allele does not either independently or acting synergistically with the ACE D allele increase the risk of restenosis after PTCA, and that apo E genotyping will not be a useful predictor of risk before the procedure.

Gongylonematiasis in the common marmoset (Callithrix jacchus)

Two cases of gongylonematiasis in common marmosets of two research facilities in Germany are reported. The helminthiasis was transmitted from colony A to colony B by one infected female and within colony B by cockroaches (Blatella germanica). Four of 40 cockroaches examined in colony B were infected with rhabditiform larvae. Clinical signs of disease in the infected animals consisted of intense itching and scratching of the edematous and slightly hyperemic perioral tissues. Histologically the adult helminths lodged predominantly in the mucous membranes of the upper and lower lips; they were less frequently present in the labial cutaneous parts or in the tongue and could not be seen in the esophageal wall, bronchi, or abdominal organs. The helminthic infection probably caused minor to moderate mixed inflammatory infiltrates of the periesophageal connective tissues and intense inflammation of the deep lingual muscular tissues. Lesions of the mucosal membranes of the lips and tongue had predominant accumulations of neutrophilic granulocytes, lymphocytes, and mostly degranulated mast cells with only a few eosinophilic granulocytes. In the cutaneous part of the lips multifocal microabscesses were considered to be secondary lesions from the intense scratching.