Efficient production of a polyhydroxyalkanoate by Azotobacter vinelandii OP using apple residues as promising feedstock

Fruit residues are attractive substrates for the production of bacterial polyhydroxyalkanoates due to the high contents of fermentable sugars and the fast, simple, and efficient pretreatment methods required. In this study, apple residues, mainly apple peel, were used as the sole carbon source in cultures of the bacterium Azotobacter vinelandii OP to produce poly-3-hydroxybutyrate (P3HB). Conversion from the residue to total sugars was highly effective, achieving conversions of up to 65.4 % w w^-1 when using 1 % v v^-1 sulfuric acid and 58.3 % w w^-1 in the absence of acid (only water). The cultures were evaluated at the shake-flask scale and in 3-L bioreactors using a defined medium under nitrogen starvation conditions. The results showed the production of up to 3.94 g L^-1 P3HB in a bioreactor, reaching an accumulation of 67.3 % w w^-1 when using apple residues. For the PHB obtained from the cultures with apple residues, a melting point of 179.99 °C and a maximum degradation temperature of 274.64 °C were calculated. A P3HB production strategy is shown using easily hydrolysable fruit residues to achieve production yields comparable to those obtained with pure sugars under similar cultivation conditions.

An international survey in Latin America on the practice of interventional cardiology during the COVID-19 pandemic, with a particular focus on myocardial infarction

Introduction

A reduction in the number of interventional cardiology procedures has emerged as a result of the COVID-19 pandemic. A survey was performed to quantify this decrease and the impact on the management of myocardial infarction in Latin America.

Methods

A telematic survey was conducted for all countries in Latin America. Diagnostic catheterisations, coronary and structural interventions, as well as the incidence and delay to reperfusion therapy of myocardial infarction (STEMI), were recorded. Two periods were compared: from 24 February to 8 March 2020 (pre-COVID-19) and another 2‑week period that varied according to country (COVID-19).

Results

Responses were obtained from 79 centres in 20 countries. There was a significant decrease in the number of diagnostic procedures (−65.2%), coronary interventions (−59.4%), structural therapeutics (−86.1%) and STEMI care (−51.2%). A decrease was noted in the incidence of STEMI, but also a delay in the time to STEMI reperfusion. While there was a variation in activity in interventional cardiology between countries, patient behaviour was rather homogeneous.

Conclusions

A significant reduction in healthcare activity has been noted during the COVID-19 pandemic, including STEMI care, with the risk of increased mortality and/or morbidity following STEMI. Healthcare providers should encourage patients with suspected symptoms of STEMI to call for emergency care to ensure rapid diagnosis and timely reperfusion treatment.

Electronic supplementary material

The online version of this article (10.1007/s12471-020-01440-y) contains supplementary material which is available to authorized users.

Tuberculosis in recipients of solid-organ transplants during 1995-2015 in Cali, Colombia

SETTING

Tuberculosis (TB) in solid-organ transplants (SOTs) is an important opportunistic infection associated with mortality and graft loss. SOT recipients carry a higher risk of contracting active TB than the general population. Clinical and radiographic presentations are non-specific, and sputum smear and culture have low yields. TB patients with SOTs require standard anti-tuberculosis treatment. However, rifampicin (RMP) use is associated with a 30% rate of acute graft rejection (AGR) and a 20% rate of transplant loss.

OBJECTIVE

To determine treatment outcomes in SOT recipients with active TB.

DESIGN

A retrospective study of clinical and microbiological data and TB treatment outcomes.

RESULTS

Among the 2349 transplants assessed, active TB was detected in 31 recipients; 55% had pulmonary TB and 40% were sputum smear-positive. In 32% of the patients, TB was diagnosed 30 days after symptom onset, 77% of the patients were cured and 10% died. AGR occurred in 13%.

CONCLUSION

TB was diagnosed in <30 days. Anti-tuberculosis treatment without RMP (80% vs. 67%; P = 0.48, OR 0.5, 95%CI 0.07-3.55) and with moxifloxacin yielded higher treatment success rates and a lower risk of AGR.

Comprehensive genomic profiling aids in treatment of a metastatic endometrial cancer

FGFR-TACC fusions, including FGFR3-TACC3, have been identified as potential oncogenic drivers and actionable alterations in a number of different cancer types. The clinical relevance of FGFR3-TACC3 fusions in endometrial cancer has not yet been described. Formalin-fixed, paraffin-embedded metastatic endometrial carcinoma from the spleen and peritoneum were sent for comprehensive genomic profiling (CGP) using the FoundationOne platform as part of a prospective tumor genomic profiling protocol. We report the identification of an FGFR3-TACC3 fusion in a case of metastatic endometrioid endometrial cancer. Other potentially actionable alterations detected in this specimen included PIK3CA T1025S and an uncharacterized rearrangement involving TSC2. The patient initially received an FGFR inhibitor as an investigational agent and experienced stable disease with complete resolution of a pelvic nodule; however, treatment had to be discontinued because of intolerable side effects. A PET/CT scan nearly 3 mo after discontinuation showed disease progression. She subsequently received the mTOR inhibitor, temsirolimus, later accompanied by letrozole, and achieved stable disease. Clinical benefit was attributed to the mTOR inhibitor as tumor stained negative for estrogen receptor. Temsirolimus was discontinued after >17 mo because of disease progression. FGFR inhibitors may have clinical benefit in the treatment of endometrial carcinoma with FGFR3-TACC3 fusions. Additionally, clinical benefit from an mTOR inhibitor may reflect a response to targeting the alteration in PIK3CA or TSC2. More research is needed to understand the activity of FGFR3-TACC3 fusions on tumors and to discover additional therapeutic options for endometrial carcinoma patients with this gene fusion.

Feasibility of collaborative precision medicine oncology between academic- and community-based hospitals

e18015

Background: The Rutgers Cancer Institute of New Jersey (CINJ) is conducting an ongoing, prospective, observational clinical trial that is evaluating use of comprehensive genomic profiling (CGP) and molecular tumor board (MTB) review to assist in caring for patients with rare or refractory cancers. As part of this precision medicine approach to cancer care, CINJ has formed a partnership with community hospitals (Meridian Health) to enroll patients in this study, and to actively participate in MTB meetings. The purpose of this cohort analysis is to evaluate the feasibility of using CGP to identify clinically-relevant genomic alterations as an aid to guiding point-of-care management in a community hospital setting. Methods: Meridian Health staff was trained in patient selection, enrollment, and follow-up. CGP was performed by Foundation Medicine, Inc. The patient case’s clinical history, pathology, and CGP results were presented at an MTB meeting. The enrolling physicians (n = 11) were invited to attend the MTB in person or through web-accessible video conferencing. A letter listing MTB consensus recommendations on potential treatment options was sent to the referring physician, and patient follow-up was scheduled at regular intervals. Results: 35 patients were enrolled by Meridian Health. Gyn and GI cancers were the most common types at enrollment (each 26%, 9 out of 35), followed by breast cancer (20%, 7 out of 35). At study enrollment, the mean KPS was 91%, and 23 patients (66%) had stage IV disease. The median duration between study enrollment and MTB presentation was 44 days. 3 patients were excluded because of deteriorated clinical status at the time of the MTB. MTB-based treatment options were implemented in 9 of 32 patients (28%). This result is similar to those reported in published analyses of patients enrolled at CINJ. Conclusions: Collaborations between an academic cancer center and a community hospital is a feasible approach to facilitating access to precision medicine for cancer patients treated in the community. A larger cohort is needed to determine the impact on patient’s outcomes.

Molecular Characterization of Epithelial Ovarian Cancer: Implications for Diagnosis and Treatment

Epithelial ovarian cancer is a highly heterogeneous disease characterized by multiple histological subtypes. Molecular diversity has been shown to occur within specific histological subtypes of epithelial ovarian cancer, between different tumors of an individual patient, as well as within individual tumors. Recent advances in the molecular characterization of epithelial ovarian cancer tumors have provided the basis for a simplified classification scheme in which these cancers are classified as either type I or type II tumors, and these two categories have implications regarding disease pathogenesis and prognosis. Molecular analyses, primarily based on next-generation sequencing, otherwise known as high-throughput sequencing, are allowing for further refinement of ovarian cancer classification, facilitating the elucidation of the site(s) of precursor lesions of high-grade serous ovarian cancer, and providing insight into the processes of clonal selection and evolution that may be associated with development of chemoresistance. Potential therapeutic targets have been identified from recent molecular profiling studies of these tumors, and the effectiveness and safety of a number of specific targeted therapies have been evaluated or are currently being studied for the treatment of women with this disease.

Use of comprehensive genomic profiling to direct point-of-care management of patients with gynecologic cancers

OBJECTIVE

To determine the feasibility and clinical utility of using comprehensive genomic profiling (CGP) in the course of clinical care to identify clinically relevant tumor genomic alterations for patients with either rare or refractory gynecologic cancers to facilitate point-of-care management. Use of an expert, multidisciplinary, institutional molecular tumor board (MTB) assessment is discussed regarding input on putative targeted options for individualized therapy.

METHODS

A prospective clinical trial is ongoing. We report on the initial 69 patients with gynecologic cancers that were either rare or refractory to standard therapy. CGP was performed by Foundation Medicine, Inc. Genomic alterations were reviewed by members of an MTB. Consensus recommendations on genomically targeted, FDA-approved, on- and off-label therapies and clinical trials were sent to the treating physician, and decisions and outcomes were assessed.

RESULTS

Study outcomes were available for 64 patients. The mean number of genes altered per tumor was 4.97 (median=4; range, 1-26), and the average turnaround time from testing laboratory report to generation of formal recommendations was approximately three weeks. Evaluation of genomic and clinical data by the MTB led to generation of targeted treatment options in all 64 patients, and the percentage of patients for whom one or more of these recommendations were implemented by the treating physician was 39%. Sixty-four percent of the patients receiving targeted therapy based on a CGP result experienced radiologic response or showed evidence of clinical benefit or stable disease.

CONCLUSION

These data suggest that an institutional MTB is a feasible venue for reviewing tumor genomic profiling results and generating clinical recommendations. These data also support the need for further studies and guidelines on clinical decision making with greater availability of broad genomically based diagnostics.

Abstract 3183: Delivery of point-of-care management to patients with gynecologic malignancies using comprehensive genomic profiling

INTRODUCTION: Gynecologic cancers were estimated to occur in 98,280 women in 2015 in the United States and result in 30,440 deaths (Siegel 2015). The most common forms of gynecologic cancers occur in the ovary and uterine corpus (Siegel, 2015). Various reasons for poor outcome in these cancers include the late stage of the disease at the time of diagnosis and therapy resistance. We sought to elucidate alternate treatment avenues based on the genomic profiles of recalcitrant or rare gynecologic tumors. In the process, we aim to determine both the clinical utility and the feasibility of using comprehensive genomic profiling (CGP) during clinical care to identify clinically relevant tumor genomic alterations for these patients while enabling point-of-care management.

METHODS: As part of our ongoing prospective clinical trial, we report on the initial 69 patients with gynecologic cancers that were refractory to standard therapy. CGP was performed by Foundation Medicine, Inc. Genomic mutations and alterations were reviewed by members of an expert, multidisciplinary institutional molecular tumor board (MTB). Consensus recommendations by the MTB were provided to the treating physician on genomically targeted, clinically relevant, FDA-approved, on- and off-label therapies and clinical trials. The outcomes were assessed.

RESULTS: Study outcomes were available for 64 patients. On average, patients had 4.97 genomic alterations per tumor (range 1-46), while the time from the testing laboratory report to the formulation of recommendations by the MTB was approximately 3-4 weeks. Targeted

treatment options were recommended by the MTB for 93% of patients; 39% of these patients had the MTB-based recommendations implemented by the treating physician. A response or clinical benefit was seen in 56% of the patients receiving MTB-based targeted therapy.

CONCLUSION: These data suggest that alternatives to standard therapies for recalcitrant gynecologic cancers can be found though CGP and subsequent analysis from members of an expert, multidisciplinary institutional MTB. The formulation of clinical recommendations by an MTB based on tumor genomic profiling results is a feasible option. Further research is needed to understand how this approach shapes clinical decision making.

Citation Format: Lorna Rodriguez-Rodriguez, Kim M. Hirshfield, Veronica Rojas, Siraj Ali, Robert S. DiPaola, Darlene Gibbon, Sara Isani, Aliza Leiser, Gregory M. Riedlinger, Shridar Ganesan. Delivery of point-of-care management to patients with gynecologic malignancies using comprehensive genomic profiling. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3183.

Abstract 2288: Targeting mTOR pathway in rare and recalcitrant tumors

INTRODUCTION: Genomic alterations affecting the PI3K/AKT/mTOR pathway are commonly seen among various cancer types [Kandoth 2013]. The objective of this study is to determine the clinical utility of using comprehensive genomic profiling (CGP) in the course of clinical care to identify genomic alterations affecting the PI3K/AKT/mTOR pathway in patients with either rare or refractory cancers.

METHODS: CGP was performed by Foundation Medicine, Inc. Genomic alterations were reviewed by members of an institutional molecular tumor board (MTB). Consensus recommendations on genomically targeted, clinically relevant FDA-approved, on- and off-label therapies and clinical trials were sent to the treating physician for their consideration as treatment alternatives. Ninety-seven tumors with alterations in the PI3K/AKT/mTOR pathway were analyzed.

RESULTS: Thirty-three patients with cancers that were either rare or refractory to standard therapy received drug targeting the PI3K/AKT/mTOR pathway. Age range was 18-78 years old. Thirteen patients were non-Hispanic White, three non-Hispanic Black, two Hispanic and one Asian. Tumors tested included 6 gynecologic, 5 renal, 2 sarcomas and one each of pancreatic, melanoma, T cell lymphoma, bladder, adrenal, and skin-not melanoma. Treatment outcomes were available for 19/33 patients (one patient died soon after presentation at the MTB and could not be treated). Seven (37%) patients derived clinical benefit from a drug targeting the PI3K/AKT/mTOR pathway; the duration of clinical benefit ranged from 90-245 days. The clinical benefit was not tumor type specific and included two endometrial tumors, 2 renal tumors, one sarcoma, one adrenal paraganglioma and one micropapillary urothelial carcinoma. Eight patients have not been started on PI3K/AKT/mTOR targeted therapy yet.

CONCLUSION: These data suggest that tumors with alterations in the PI3K/AKT/mTOR pathway may respond to targeted therapy regardless of tumor of origin.

Citation Format: Veronica Rojas, Shridar Ganesan, Kim M. Hirshfield, Robert S. Dipaola, Lorna Rodriguez-Rodriguez. Targeting mTOR pathway in rare and recalcitrant tumors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2288.

Pro-inflammatory caspase-1 activation during the immune response in cells from rainbow trout Oncorhynchus mykiss (Walbaum 1792) challenged with pathogen-associated molecular patterns

In response to pathogens, the higher vertebrate innate immune system activates pro-inflammatory caspase-1 which is responsible for the processing and secretion of several important cytokines involved in the host's defence against infection. To date, caspase-1 has been described in few teleost fish, and its activity has been demonstrated through substrate cleavage and inhibition by pharmacological agents. In this study, the detection of the active form of caspase-1 during the immune response in salmonid fish is described, where two antibodies were produced. These antibodies differentially recognize the structural epitopes of the inactive pro-caspase-1 and the processed active form of the caspase. Firstly, caspase-1 activation was demonstrated in vitro by ELISA, Western blotting and immunocytochemistry in rainbow trout macrophages exposed to different pathogen-associated molecular patterns plus the pathogen Aeromonas hydrophila. This activity was clearly abrogated by a caspase inhibitor and seems to be unrelated to IL-1β secretion. Caspase-1 activation was then validated in vivo in gill cells from fish challenged with Aeromonas salmonicida. These results represent the first demonstration of caspase-1 activation in salmonids, and the first evidence of the putative regulatory role which this protease plays in inflammatory response in this fish group, as described for some other teleosts and mammals.

The O3-Vet project: integration of a standard nomenclature of clinical terms in a veterinary electronic medical record for veterinary hospitals

In order to improve the hospital information system of the Chilean University Hospital, the Veterinary Medicine School of Universidad de Chile made a research cooperation with Università San Raffaele Roma to develop and test a new release of the O3-Vet software application. O3-Vet was selected by the Chilean University mainly for two reasons: (1) it uses human medicine standardized technologies such as "Health Level 7" (HL7) and "Integrating the Healthcare Enterprise" (IHE), which allow a good level of data sharing and hospital management; (2) it is open source, which means it can be adapted to specific hospital needs. In the new release, a subset of diagnostic terms was added from the "Systematized Nomenclature of Medicine Clinical Terms" (SNOMED CT), selected by the "American Animal Hospital Association" (AAHA) to standardize the filing of clinical data and its retrieval. Results from a limited survey of veterinarians of the University (n=9) show that the new release improved the management of the Chilean University Hospital and the ability to retrieve useful clinical data.

Development of a new antibody for detecting natural killer enhancing factor (NKEF)-like protein in infected salmonids

The main cellular responses of innate immunity are phagocytic activity and the respiratory burst, which produces a high amount of reactive oxygen species. Natural killer enhancing factor (NKEF) belongs to the peroxiredoxin family that has an antioxidant function and enhances cytotoxic cell activity. This molecule may play a key role in macrophage and cytotoxic cell communication during the innate immune response of fish against pathogens. In fish, the NKEF gene has been characterized in some species as showing an up-regulation in infected fish, suggesting a trigger effect upon NK-like cells. To detect and localize this molecule in salmonids at protein level, a monospecific polyclonal antibody was generated. A probable NKEF-like protein epitope region was identified and characterized using bioinformatic tools, and the sequence was chemically synthesized using Fmoc strategy, analysed by RP-HPLC and its molecular weight confirmed by mass spectrometry. The synthetic peptide was immunized and antibodies from ascitic fluid were obtained. The resulting antibody is a versatile tool for detecting NKEF by different immune techniques such as ELISA, Western blotting and immunohistochemistry. Analysis of NKEF-like protein is a useful method for characterizing immune properties of this molecule in fish during response to pathogens.

Review of benzodiazepine use in children and adolescents

Clinically, benzodiazepines are used in adult populations much more frequently than in children and adolescents. There may be a number of reasons for this disparity including a dearth of well controlled clinical studies and the issue of dependence associated with long term use. However, over a ten year span there has been nearly a three fold increase in the use patterns for these agents in the child population. In open studies much of the literature has indicated potentially useful results, but these findings have not been replicated when more refined methodological studies have been conducted. The lack of encouraging results in these later studies may be attributable to a number of factors such as modest sample sizes and less than optimal patient selection. Nonetheless, with increasing prescriptions being written for these agents it is not clear what is compelling clinicians to use them. In this paper we will review the available literature on benzodiazepine use in the child and adolescent population, focusing primarily on psychiatric applications.

Studies on acetate ester production by non-saccharomyces wine yeasts

A double coupling bioreactor system was used to fast screen yeast strains for the production of acetate esters. Eleven yeast strains were used belonging to the genera Candida, Hanseniaspora, Metschnikowia, Pichia, Schizosaccharomyces and Zygosacharomyces, mainly isolated from grapes and wine, and two wine Saccharomyces cerevisiae strains. The acetate ester forming activities of yeast strains belonging to the genera Hanseniaspora (Hanseniaspora guilliermondii and H. uvarum) and Pichia (Pichia anomala) showed different substrate specificities and were able to produce ethyl acetate, geranyl acetate, isoamyl acetate and 2-phenylethyl acetate. The influence of aeration culture conditions on the formation of acetate esters by non-Saccharomyces wine yeast and S. cerevisiae was examined by growing the yeasts on synthetic microbiological medium. S. cerevisiae produced low levels of acetate esters when the cells were cultured under highly aeration conditions, while, under the same conditions, H. guilliermondii 11104 and P. anomala 10590 were found to be strong producers of 2-phenylethyl acetate and isoamyl acetate, respectively.

[Aflatoxins in newly harvested corn in Panama]

Mycotoxins are fungal metabolites that may contaminate foods and feeds, resulting at times in important disease in humans and animals. Thirty-six samples of nine varieties of newly harvested corn (4 samples each variety) were analyzed in search of aflatoxins by thin layer chromatography and high pressure liquid chromatography, and also cultured for the presence of Aspergillus flavus. Of the 36 samples studied, one was contaminated with 1290 ppb aflatoxin B1, which is 258x the concentration suggested by WHO, placed at 5 ppb in food for human consumption. Culture of the 36 samples of corn resulted in growth of 55 colonies of A. flavus from all but two (1 and 6) of the 9 varieties. Of the 55 colonies of A. flavus obtained, 15 (27.3%) were toxigenic. Comments are made on the public health implications of these findings.

[Knowledge, beliefs, and practices related to acute respiratory infections in adults over 65 years old]

Knowledge, beliefs, and practices related to acute respiratory infections (ARIs) in individuals caring for the elderly (over 65 years of age) were evaluated. Home interviews were conducted with 245 persons: 136 lived in urban areas and 109 in rural areas. Mean age was 62 years. All interviewees could read and write. Some 52% of the elderly cared for themselves. A total of 33% smoked. They were generally unaware of the severity of signs and symptoms in ARIs (37% could not mention any). Some 47% did not follow the physician's orders. Self-medication with antibiotics was commonplace. A total of 28% failed to increase liquid intake during the course of ARIs. The results demonstrated insufficient knowledge and management of ARIs in the elderly. An educational program and specific intervention were conducted to improve the situation identified by the study.

[Antimicrobial resistance of different Acinetobacter baumannii biotypes isolated in the northern region of Chile]

BACKGROUND

Acinetobacter baumannii nosocomial outbreaks are common and the microorganism is frequently resistant to multiple antimicrobials. There is little information about Acinetobacter baumannii antimicrobial susceptibility in the northern region of Chile.

AIM

To identify different Acinetobacter baumannii biotypes isolated from clinical samples and to determine their antimicrobial susceptibility.

MATERIAL AND METHODS

One hundred twenty three Acinetobacter baumannii isolates were studied. The identification and typing of Acinetobacter baumannii was based on phenotypic characteristics. Antimicrobial susceptibility was investigated using agar dilution techniques.

RESULTS

Most Acinetobacter baumannii strains were isolated from wounds, urinary and respiratory infections. Seven biotypes were isolated, being biotype 9 the most frequent. Imipenem was the antimicrobial with the higher activity against the microorganism. Amikacin, cefoperazonesulbactam, ampicillinsulbactam and ceftazidime had a moderate activity. There were high resistance levels to ampicillin and older cephalosporins.

CONCLUSIONS

Acinetobacter baumannii is emerging as a significant nosocomial pathogen in Chile and shows high resistance rates to multiple antibiotics.

[High prevalence of undiagnosed primary hyperaldosteronism among patients with essential hypertension]

BACKGROUND

Classically, primary hyperaldosteronism was diagnosed in no more than 1% of patients with hypertension, when hypokalemia was used as the screening test. However, numerous patients with primary hyperaldosteronism do not have hypokalemia and the disease remains undiagnosed.

AIM

To assess the prevalence of normokalemic primary hyperaldosteronism among patients classified as having essential hypertension.

PATIENTS AND METHODS

One hundred hypertensive patients with a blood pressure over 145/95 were studied. Plasma aldosterone and plasma renin activity were measured in all. A primary hyperaldosteronism was diagnosed when high aldosterone levels (over 16 ng/dl) and low plasma renin activity (below 0.5 ng/ml/h) coexisted in two blood tests or the aldosterone/plasma renin activity ratio was over 50. A probable primary hyperaldosteronism was diagnosed when the ratio was between 25 and 50 and these patients were subjected to a Fludrocortisone test to confirm the diagnosis. A dexametasone suppression test was done to discard glucocorticoid remediable aldosteronism. An adrenal TAC scan was done to all patients with primary hyperaldosteronism.

RESULTS

A diagnosis of primary hyperaldosteronism was reached in ten patients. Seven had elevated aldosterone and low plasma renin activity. In three the diagnosis was confirmed with the fludrocortisone test. All ten patients had normal serum potassium levels. Dexametasone suppression test was positive in three patients, that normalized their blood pressure levels. Adrenal TAC scans showed an adenoma in one patient and hyperplasia in another.

CONCLUSIONS

Primary hyperaldosteronism is more frequent than previously thought, it is overlooked when hypokalemia is used as the screening test and it can only be diagnosed measuring plasma aldosterone and renin activity.

[Cryptococcus neoformans isolation from the soil in Panama]

Reports of Cryptococcus neoformans isolations from patients in Panama have appeared since 1978, but to our knowledge, thIs is the first report of isolation of this organism from soil samples in the Republic. Of 25 soil samples analyzed, two (25%) yielded the organism on birdseed agar medium. Canavanine-glycine-bromthymol blue medium served to identify the isolates as belonging to C. neorformans var neoformans, and not C. Neoformans var. gattii. Initially, isolates did not have capsules, but upon passage through newborn mice, wide capsules developed. This finding has important public health implications, since non-encapsulated environmental organisms, once in the host, can develop capsules, which significantly contribute to virulence.

Infectious bronchitis: effect of viral doses and routes on specific lacrimal and serum antibody responses in chickens

An enzyme-linked immunosorbent assay was used to measure the effect of various infectious bronchitis virus (IBV) (strain H-120) vaccine doses and routes of immunization on specific lacrimal and serum antibody responses. The results of the first trial showed that the maximum dose, 10(6) median embryo infective doses (EID50s), delivered by the ocular route elicited both a systemic and a local antibody response in the vaccinated chickens. Lower doses of vaccinal virus, 10(4) (median dose) and 10(2) (minimum dose) EID50 delivered by the same route did not induce a detectable systemic antibody response. A significant increase of IBV-specific lacrimal IgA was elicited by both the maximum and the median vaccine doses. The low vaccine dose (10(2) EID50) did not induce a detectable increase of lacrimal IgA. In a second trial approximately the same vaccine dose was administered to different chicken groups by ocular instillation, drinking water, spray, and cloaca. The results showed that all routes of vaccination tested, including the cloacal route, resulted in an increase of specific serum antibodies. Higher IgG levels were detected throughout the experimental period after vaccination by the ocular route as compared with vaccination via the drinking water. All routes of vaccination tested resulted in an increase of specific IgA in lacrimal fluid. The vaccine application methods spray, ocular instillation, and drinking water induced similar lacrimal IgA responses.

Altered cortisol response and hippocampal atrophy in pediatric HIV disease

The hippocampus is a major center for the regulation of the hypothalamic-pituitary-adrenal axis. There is experimental evidence that chronic exposure to high levels of glucocorticoids may be toxic to the hippocampus. We observed elevated mean basal and 60-min cortisol (F) levels in response to adrenocorticotropin stimulation (0.25 mg cortrosyn, i.v. bolus infusion) in 15 children with HIV infection. Furthermore, in eight of the children for whom data was available, in addition to high peripheral cortisol levels, neurologic dysfunction and hippocampal atrophy were noted on CT scan. These preliminary data suggest that in HIV-infected children an altered cortisol secretion may be associated with specific central nervous system damage.

An epitope of the transferrin receptor is exposed on the cell surface of high-grade but not low-grade human lymphomas

In attempting to identify antigens that are differentially expressed on tumor cells following transformation from follicular small cleaved cell lymphoma (FSC) to immunoblastic lymphoma (IL), we identified a unique epitope of the transferrin receptor (TfR). The epitope is available for binding in aggressive lymphomas but not in indolent lymphomas or normal cells. An immunoglobulin G2a (IgG2a) antibody that binds this epitope, Trump, was produced by screening on tumor cells from a patient who initially had a low-grade lymphoma which subsequently converted to a high-grade lymphoma. Immunoprecipitation and comodulation studies show that Trump binds to the TfR, but blocking studies and immunostaining reveal that the TfR epitope seen by Trump is distinct from the OKT9 and anti-TfR binding sites. The ability of Trump to discriminate a separate population of more highly malignant cells suggests that the expression of the Trump epitope is determined by the state of activation or degree of malignancy of the cell. In addition, it may be possible to use the Trump antibody diagnostically or therapeutically in the management of lymphomas.