Immune responses of cattle to experimental anti-Fasciola hepatica vaccines

Fasciola hepatica infection of cattle and sheep is an important cause of clinical disease and production losses, and is controlled at present by a combination of chemotherapy and management measures. However, the prospects for the control of F. hepatica infection by vaccination are good, and we have previously shown substantial protection of cattle against experimental challenge infection following immunisation with a combination of the purified fluke-derived enzymes cathepsin L1 (CATL 1), cathepsin L2 (CATL 2) and fluke-derived Hb fraction (FHB). This and other recent studies have also demonstrated fundamental differences between protective and non-protective immune responses to liver fluke infection. In this present study we have further analysed the response of animals to liver fluke challenge following experimental vaccination. Calves were vaccinated with either CATL 2 plus FHB, or CATL 1 plus CATL 2. Partial protection against challenge infection was achieved in both vaccinated groups, with the greatest level of protection (55 per cent reduction in fluke burdens) recorded in the group vaccinated with CATL 1 plus CATL 2. This latter group also showed the greater level of lymphocyte proliferation and the greater production of gamma-INF in response to stimulation with fluke antigen in vitro following challenge. These results are significant in our attempts to characterise the elements within the immune response to vaccination which are protective.

Assessment of routine use of an anaerobic bottle in a three-component, high-volume blood culture system

The relative value of routine anaerobic blood culture for recovery of organisms and identification of episodes of bloodstream infection was assessed in a three-component, high-volume blood culture system which employs aerobic and anaerobic bottles of BacT/Alert (Organon-Teknika, Durham, N.C.) and aerobic cultures of Isolator (Wampole Laboratories, Cranbury, N.J.). The results of 5,595 blood culture sets from patients with suspected bloodstream infection were analyzed. Compared with either the aerobic BacT/Alert bottle or aerobic culture of Isolator, the BacT/Alert anaerobic bottle recovered significantly fewer isolates (242 versus 294, P < 0.05; 242 versus 298, P < 0.05) but did not detect significantly fewer episodes of bloodstream infection (141 versus 157, P > 0.05; 141 versus 147, P > 0.05). The BacT/Alert anaerobic bottle recovered significantly more isolates of obligately anaerobic bacteria (16 versus 4, P < 0.05; 16 versus 0, P < 0.05) and detected significantly more episodes of bloodstream infection caused by obligately anaerobic bacteria (10 versus 3, P < 0.05; 10 versus 0, P < 0.05) than either the aerobic bottle of BacT/Alert or the aerobic culture of Isolator. The combination of the BacT/Alert anaerobic bottle and the aerobic culture of Isolator recovered as may isolates (374 versus 377) and detected as many episodes of bloodstream infection (194 versus 191) as the combination of the aerobic bottle of BacT/Alert and the aerobic culture of Isolator, and both of these combinations identified at least 8% more isolates and detected at least 3% more bloodstream infections than the combination of the BacT/Alert aerobic and anaerobic bottles. Further analysis of the data revealed that the utility of the BacT/Alert anaerobic bottle, especially when combined with the aerobic culture of Isolator, resulted from not only enhanced recovery of obligately anaerobic bacteria but also effective recovery of facultatively anaerobic bacteria. These results demonstrate the utility of the anaerobic BacT/Alert bottle for detecting bloodstream infection caused by either facultatively anaerobic bacteria or obligately anaerobic bacteria and support the routine inclusion of anaerobic blood culture in the three-component blood culture system used in our hospital.

Clinical comparison of the isolator and BacT/Alert aerobic blood culture systems

The performance characteristics of the Isolator (Wampole Laboratories, Cranbury, N.J.) and the BacT/Alert (Organon Teknika Corporation, Durham, N.C.) aerobic blood culture systems were compared for 6,009 blood culture sets obtained from patients with suspected bloodstream infections. The BacT/Alert aerobic bottle [BTA(O2)] was continuously agitated while it was incubated in 5% CO2 at 36 degrees C; culture plates prepared from the Isolator tube [I(O2)] were incubated in 5% CO2 at 37 degrees C. From 394 blood cultures, 416 clinically significant isolates of bacteria and yeasts were recovered. The overall yields for BTA(O2) and I(O2) were not significantly different (319 versus 336; P = 0.20). I(O2) recovered significantly more staphylococcus (P < 0.05) and yeast isolates (P < 0.01). BTA(O2) recovered significantly more aerobic and facultatively anaerobic gram-negative bacilli (P < 0.05). In blood culture sets which produced growth of the same organisms in both the BTA(O2) and I(O2) systems, the BTA(O2) system detected growth sooner, but more rapid identification was possible with the I(O2) system by virtue of earlier isolation of colonies on solid media.

Recurrent adult myofibromatosis. A case report

Myofibromatosis generally is regarded as a fibrous proliferative disease of neonates and children that, even when multicentric, has an excellent prognosis and a propensity for spontaneous involution. Reported is a case of solitary, locally recurrent myofibromatosis in the ear canal of an adult patient. It was initially thought to be a leiomyoma. The diagnosis of myofibromatosis was made on the basis of its histologic appearance and corroborated by immunohistochemical stains. Clinicians and pathologists should be aware that myofibromatosis may occur in adults in unusual locations, with a potential for local recurrence. Furthermore, its histologic appearance may mimic that of other mesenchymal neoplasms.

Angiomyolipoma of kidney with lymph node involvement. DNA flow cytometric analysis

We performed DNA flow-cytometric analysis in three cases of angiomyolipoma of the kidney with lymph node involvement. The primary tumors of the kidneys and tumors in the lymph nodes of all patients contained diploid DNA. All three patients have been monitored for longer than 1 year and have no evidence of recurrence or metastasis. The lack of aneuploidy in both the kidney and the lymph nodes in our patients, although not excluding malignant neoplasia, supports the benign and multifocal nature of this lesion. Larger studies with long-term follow-up are reported to confirm this conclusion.

Unexpected splenic nodules in leukemic patients

We reviewed a series of five splenectomy specimens from patients with various leukemias (three cases of chronic myelocytic leukemia, one case of acute myelocytic leukemia, and one case of hairy cell leukemia). In addition to diffuse red pulp disease, we unexpectedly encountered nodules grossly in each of the specimens. These represented sea blue histiocytosis (one case), focal hairy cell leukemia (one case), localized blast transformation (one case), and concentrated foci of treated leukemia (two cases), with a prominence of immature granulocytic precursors on a background of trilineage hyperplasia. These cases are reported because they are unusual and because they furnish interesting correlates of gross and microscopic anatomy.

Fatal acute spontaneous endometritis resulting from Clostridium sordelli

Intrauterine clostridial infections have historically been associated with puerperal sepsis, often subsequent to instrumented abortions. Isolated reports have been associated with a malignant neoplasm or degenerating leiomyoma, most often after instrumentation, radiation therapy, or chemotherapy. In these cases, well-known risk factors or obvious niduses for growth and causation of disease were identified. The authors report a case of fatal spontaneous endometritis resulting from Clostridum sordellii, which, to their knowledge, has not been previously reported in the literature. Characteristics of this rare virulent human pathogen are discussed.

Blue nevus and melanosis of the prostate. Electron-microscopic and immunohistochemical studies

Two cases of blue nevus and one case of melanosis of the prostate were studied with ultrastructural and immunohistochemical methods. All patients complained of urinary obstruction, and the clinical impression in all was benign prostatic hyperplasia. Melanin was present in the stroma of the prostate in all cases. In one, pigment was also demonstrated both in benign and malignant epithelial cells. Electron microscopically, melanosomes in different stages were present in the two white patients, but only mature stage IV melanosomes were demonstrated in the black patient. The melanin in epithelial cells consisted only of mature melanosomes. Immunohistochemically, the stromal cells that contained melanin stained with S-100 protein. The evidence suggests that the pigmented cells in the prostatic stroma are melanocytes and the melanin in the glandular epithelium is a result of the transfer of pigment from the stromal melanocytes.