Geothermobacter hydrogeniphilus sp. nov., a mesophilic, iron(III)-reducing bacterium from seafloor/subseafloor environments in the Pacific Ocean, and emended description of the genus Geothermobacter

A novel mesophilic, anaerobic, mixotrophic bacterium, with designated strains EPR-M^T and HR-1, was isolated from a semi-extinct hydrothermal vent at the East Pacific Rise and from an Fe-mat at Lō'ihi Seamount, respectively. The cells were Gram-negative, pleomorphic rods of about 2.0 µm in length and 0.5 µm in width. Strain EPR-M^T grew between 25 and 45 °C (optimum, 37.5-40 °C), 10 and 50 g l^-1 NaCl (optimum, 15-20 g l^-1) and pH 5.5 and 8.6 (optimum, pH 6.4). Strain HR-1 grew between 20 and 45 °C (optimum, 37.5-40 °C), 10 and 50 g l^-1 NaCl (optimum, 15-25 g l^-1) and pH 5.5 and 8.6 (optimum, pH 6.4). Shortest generation times with H₂ as the primary electron donor, CO₂ as the carbon source and ferric citrate as terminal electron acceptor were 6.7 and 5.5 h for EPR-M^T and HR-1, respectively. Fe(OH)₃, MnO₂, AsO₄ ^3-, SO₄ ^2-, SeO₄ ^2-, S₂O₃ ^2-, S⁰ and NO₃ ^- were also used as terminal electron acceptors. Acetate, yeast extract, formate, lactate, tryptone and Casamino acids also served as both electron donors and carbon sources. G+C content of the genomic DNA was 59.4 mol% for strain EPR-M^T and 59.2 mol% for strain HR-1. Phylogenetic and phylogenomic analyses indicated that both strains were closely related to each other and to Geothermobacter ehrlichii, within the class δ-Proteobacteria (now within the class Desulfuromonadia). Based on phylogenetic and phylogenomic analyses in addition to physiological and biochemical characteristics, both strains were found to represent a novel species within the genus Geothermobacter, for which the name Geothermobacter hydrogeniphilus sp. nov. is proposed. Geothermobacter hydrogeniphilus is represented by type strain EPR-M^T (=JCM 32109^T=KCTC 15831^T=ATCC TSD-173^T) and strain HR-1 (=JCM 32110=KCTC 15832).

Common and differential dimensions of personal identity between psychosis and depression: The relevance of gender and depressive mood

Disturbances in personal identity are recognized in psychosis and depression. However, it is unknown whether these disruptions share common processes across clinical groups, or whether there are unique alterations by group or between men and women within each clinical group. To advance on this question, we compared personal identity dimensions in psychosis and depression and investigated the effects of gender and depressive mood. This study assessed dimensions of personal identity using the repertory grid technique among 85 outpatients with psychosis, 85 outpatients with depressive disorders and 85 healthy controls who were matched by age. Data regarding depressive mood and general functioning was also collected. Results showed that self-discrepancies were higher in psychosis and depression than in controls, and were associated with depressive mood. Interpersonal dichotomous thinking was more prevalent in women in both clinical groups. Women with psychosis showed higher ideal-others discrepancy and had a more complex structure of personal identity than their male counterparts. To conclude, alterations in self-ideal and self-others discrepancies may be transdiagnostic dimensions related to depressive mood. Interpersonal dichotomous thinking may also be a common dimensional characteristic in psychosis and depression but more specific to women. Finally, critical views of others and a higher complexity of personal identity may be more specific to women than men with psychosis. Our results are consistent with other studies pointing to the need for person-focused treatments promoting the recovery of a full sense of personal identity, rather than just focusing on specific thoughts and feelings.

Double blinded, vehicle controlled, crossover study on the efficacy of a topical endocannabinoid membrane transporter inhibitor in atopic Beagles

The endocannabinoid system is important for skin homeostasis and alterations are linked to inflammatory diseases like atopic dermatitis (AD). Importantly, activation of cannabinoid receptor CB2 decreases pruritus and inflammation in mouse models. Reduction of inactivation of endogenous cannabinoids could, therefore, be a therapeutic option for AD. Dogs spontaneously develop AD, which closely mimics the human disease making them suitable to test new therapies. Our study aimed to test the effects of a topical endocannabinoid membrane transporter inhibitor (WOL067-531, 1% gel) on pruritus and dermatitis in a canine model of AD. Nineteen Beagles allergic to dust mites (DM) were randomized to receive either active ingredient or vehicle on inguinal area while challenged epicutaneously with DM twice weekly for 28 days. Treatment was administered twice daily and started after three challenges (day 8). Dermatitis and pruritus were scored weekly by personnel blinded to treatment allocation. Dermatitis was scored using a validated scoring system and pruritus was scored using camera recordings. After a 4-week washout, dogs were crossed over and the study was repeated. On days 15 and 22, dermatitis scores were significantly increased after DM challenge in the vehicle group (16.34, p = 0.0089 and 7.42, p = 0.04845, respectively) but not in the active ingredient group (p = 0.3177 and p = 0.3190, respectively). Significant decrease on pruritus both on inguinal area and overall (p = 0.048 and p = 0.032, respectively) occurred in the active ingredient group. No adverse effects were noted. In conclusion, the newly developed topical endocannabinoid membrane transporter inhibitor (WOL067-531) minimized allergic flares and pruritus in a canine model of AD.

Follicular Development and Secretion of Ovarian Hormones during the Juvenile and Adult Reproductive Lives of the Myelin Mutant taiep Rat: An Animal Model of Demyelinating Diseases

Infertility and reproductive problems have been reported in women with several neurological disorders, for example, demyelination. However, the physiology of such problems has remained unknown so far. The taiep rats are an animal neurological model that initially shows a hypomyelination followed by a progressive demyelination of the central nervous system. This animal has reproductive problems, and the aim of this work is to characterize the follicular development, secretion of ovarian hormones, and presence of noradrenaline in the ovaries of the female taiep rats in the juvenile and adult stages. The taiep rats have low body weight (approximately 19% less than that of SD rats), a delay of 4 days in the age of vaginal opening, and an irregularity in the estrous cycle by the absence or prolongation of some estral cycle stage. In the juvenile stage, we observed a decrease of approximately 44% in the total number of follicles with a 15% increase of atresia and an 80% decrease in the fluorescence intensity of catecholamines in the ovaries, with a 21% increment in plasma concentrations of testosterone. In the adult stage, we observed follicular cysts and a 50% decrease in fluorescence intensity of catecholamines in the ovaries, with changes in the secretion of ovarian hormones, an increase of 20 times in progesterone, and a decrement of a half in estradiol. The demyelination in taiep rats affects follicular development and steroidogenesis in the early stages of the animal's life, and this is maintained until adulthood.

Effect of canagliflozin on serum uric acid in patients with type 2 diabetes mellitus

Hyperuricaemia is associated with an increased risk of gout, kidney stones and cardiovascular disease. The present post hoc analysis of pooled data from four placebo-controlled phase III studies assessed the effect of canagliflozin, a sodium-glucose co-transporter 2 inhibitor, on serum uric acid levels in patients with type 2 diabetes mellitus (T2DM) and in a subset of patients with hyperuricaemia [defined as baseline serum uric acid ≥475 µmol/l (∼8 mg/dl)]. At week 26, canagliflozin 100 and 300 mg were associated with a ∼13% reduction in serum uric acid compared with placebo. In the subset of patients with hyperuricaemia, placebo-subtracted percent reductions in serum uric acid were similar to those in the overall cohort. More patients in the hyperuricaemic group achieved a serum uric acid level of <360 µmol/l (∼6 mg/dl) with both canagliflozin 100 mg (23.5%) and 300 mg (32.4%) compared with placebo (3.1%). Incidences of gout and kidney stones were low and similar across groups. In conclusion, canagliflozin treatment decreased serum uric acid in patients with T2DM, including those with baseline hyperuricaemia.

[Cholecystolithotomy: first middle-long term results of our series]

Cholelithiasis in children is an infrequent disease whose incidence has increased over the last few decades. It has its own typical characteristics, different from those present in adults. Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cases, still its connection with right-sided colon cancer and other diseases associated with the procedure has led to recommend it with some reservation. Though several authors adopted cholecystotomy as a therapeutic option in recent years, its use remains controversial. Our indication criteria for this technique are presented herewith, as well as long- and medium-term results (mean follow-up of 10 years) of our series, previously reported in 2003, and a new case added later in 2006.

MATERIALS AND METHODS

Since 2003, a prospective study of 15 patients from our previous series and a new patient added afterwards is being carried out, including: 1) Medical history checking for symptoms connected with biliary conditions. 2) DIAGNOSTIC TESTS: laboratory tests and ultrasonography.

RESULTS

Out of our 16 patients: A girl relapsed a few months later and underwent cholecystectomy, but whether it was a true relapse or a missed gallstone was not established. A patient with a history of recurrent abdominal pain has shown no improvement in his symptoms even though his tests are normal. Two patients have been lost for our study, but showed normal tests for 5 and 7 years respectively. Our 11 remaining patients show no symptoms as well as normal laboratory and imaging tests. A new patient joined our study in 2006, showing normal tests to date and no postsurgical complications.

CONCLUSIONS

Based on our experience, cholecystotomy has proved to be a complication-free, safe and easy procedure with a virtually nonexistent relapse rate in the long and medium term for patients in the pediatric age group presenting with single or double cholelithiasis, unchanged for 1-2 years with no size increase, no apparent etiology, no complications and a normal bile duct.

Cognitive-behavioral therapy for chronic psychosis

Cognitive-behavioral therapy (CBT) has been used in recent years as an intervention for chronic psychoses, generally as a complement to the pharmacological treatment. This fact has motivated controlled studies that analyze the efficiency of this type of interventions. That is why this bibliographical review has aimed to analyze the most relevant studies up-to-date. Those works having a controlled and random design, that assured the requirements of reliability and validity, were included. The studies show encouraging results, because they support the efficiency of CBT as a measurement of treatment. Nevertheless, more investigations that support this information are still required.

Trombosis venosa cerebral neonatal. Diagnóstico por angiorresonancia magnética

Neonatal cerebral venous thrombosis (NCVT) is a rare, severe neuropathology of multiple etiology and variable clinical presentation. We describe the case of a 25-day-old infant that presented with a tonic convulsion. Ultrasound examination showed tetraventricular hemorrhage. Magnetic resonance imaging (MRI) showed the presence of acute thrombosis of the deep and superficial venous systems associated to a hemorrhagic infarct of the left thalamus. Coagulation study revealed a deficit of protein C. Thrombosis of deep cerebral veins must be ruled out as a cause of a neonatal convulsive crisis. The presence of a hemorrhagic thalamic lesion supports the diagnosis of NCVT, which must in turn be confirmed by magnetic resonance angiography (MRA).

Adhesive small bowel obstruction: predictive value of oral contrast administration on the need for surgery

INTRODUCTION

adhesive small bowel obstruction (SBO) is a common cause of hospital admission. Nonoperative management is initially recommended unless there is suspicion of strangulation, but its optimal duration is controversial. The aims of our study was to evaluate the usefulness of radiographic small bowel examination with contrast medium to predict the need for surgery in SBO.

MATERIAL AND METHODS

this prospective study carried out from January 1999 to December 2001, included 100 patients with clinical and radiological criteria of adhesive SBO. We described the past medical history, as well as clinical picture, blood tests and radiological findings in these patients. Fifty cubic centimeters of 5% barium suspension were given orally, and plain abdominal radiographs were taken at 4, 8, 16, and 24 hours afterwards. A liquid diet was given as soon as the contrast medium appeared in the right colon. Otherwise, surgical intervention was considered based on the outcome of the patient and the criteria of the emergency surgical team.

RESULTS

in 70 patients, barium contrast appeared in the right colon, and a liquid diet was tolerated by 69 of them (98.6%). Mean hospitalization time for this group was 43 +/- 17 hours. In the remaining 30 patients, no evidence of barium contrast in the right colon was seen, and 25 of them underwent surgery (75%), while the other 5 tolerated a liquid diet. Mean hospitalization time for this second group of patients was 13.8 +/- 11 days. Sensitivity, specificity, positive predictive value, and negative predictive value for the absence of contrast medium in the right colon within 24 hours as a predictor of surgery were 93, 96, 98 and 83%, respectively. There was a statistical significant relationship (p < 0.01) between the "Presence of contrast medium in the right colon" and "Oral diet tolerance". Only the variable "Number of previous surgical interventions" tended to reach statistical significance (p = 0.07). Tolerance of liquid diet was more likely when patients had more than one previous abdominal surgery.

CONCLUSIONS

early oral administration of a radiological contrast medium in patients with adhesive SBO can effectively predict the need for a surgical procedure. It can shorten not only hospital stay, but also the potential morbidity of late surgery, secondary to a prolonged and unsuccessful nonoperative treatment.

The effects of superior ovarian nerve sectioning on ovulation in the guinea pig

The effects on spontaneous ovulation associated with the unilateral or bilateral sectioning of the superior ovarian nerves (SON) were analyzed in guinea pigs at different time intervals of the estrous cycle. Day 1 of the estrous cycle was defined as the day when the animal presents complete loss of the vaginal membrane (open vagina). Subsequent phases of the cycle were determined by counting the days after Day 1. All animals were autopsied on the fifth day of the estrous cycle after surgery. Sectioning the right, left, or both SONs on day 5 (early luteal phase) resulted in a significant increase in the number of fresh corpora lutea. Ovulation increased significantly when the left SON (L-SON) was sectioned during late follicular phase (day 1) and medium luteal phase (day 8). When surgery was performed on days 1 or 8, neither sectioning the right SON (R-SON) nor sectioning the SON bilaterally had an apparent effect on ovulation rates. Similarly, ovulation rates were not affected when unilateral (right or left) or bilateral sectioning of the SON was performed during late luteal phase two (day 12). Unilateral or bilateral sectioning of the SON performed during the early luteal phase (day 5) was associated with a significant decrease in uterine weight. A comparable effect was observed when the L-SON was sectioned during late follicular phase (day 1), or medium luteal phase (day 8). No effects on uterine weight were observed when unilateral or bilateral sectioning of the SON was performed during late luteal phase. Our results suggest that in the guinea pig the SON modulates ovulation, and that the degree of modulation varies along the estrous cycle. The strongest influence of the SONs on ovulation occurs during early luteal phase, and decrease thereafter, being absent by late luteal phase. In addition, sectioning the left or the right SON caused different responses by the ovaries of adult guinea pigs. This paper discusses the mechanisms by which ovulation increased when the SON was surgically cut.

Effects of functional peripheral sympathetic denervation induced by guanethidine on follicular development and ovulation of the adult female guinea pig

The present study investigates the effects of functional sympathetic peripheral denervation induced by guanethidine sulphate (GTD) to adult female guinea pigs in the follicular (FPh) or luteal phases (LPh) on their oestrous cyclicity and ovulation. No differences were observed in oestrous cyclicity or the average number of corpora lutea present in the ovaries between the control and denervated animals. Guanethidine sulphate administration resulted in a significant decrease in ovarian norepinephrine content, higher for the left ovary than for the right one. Serum oestrogen and progesterone concentrations, the mean of follicles, and its diameter were different, depending on the oestral cycle in which the treatment was performed. These results suggest that in adult normal female guinea pigs, ovarian innervation participates in the regulation of follicular development in an inhibitory way.

[Intrathecal perfusion pump with baclofen in generalized dystonia]

OBJECTIVES

We show the effectiveness of treatment with continuous intrathecal baclofen infusion in a case of hereditary generalized dystonia refractory to anticholinergics, tetrabenazine, pimozide, L-dopa, benzodiazepines and thalamotomy.

CLINICAL CASE

A 26 years old female patient, when she was 11 years old began with torsion dystonia in her left feet, that progressively worsened to involve her entire body. She had painful spasms. She had four brothers, three of them with dystonia and one healthy. Her uncle grandfather had similar symptoms. Complementary explorations to reject secondary origin was negatives. She was treated with high and progressive dosages of anticholinergics, pimozide, tetrabenazine, benzodiazepines, L-dopa and thalamotomy without improvement. Underwent intrathecal baclofen test dosing, we used 25, 50, 100 micrograms/day, the last one with improvement during 10 hours. A pump was inserted with an initial dose of 220 micrograms/day. After pump insertion, baclofen dosage was gradually increased to 450 micrograms/day. She had a great improvement in right part of her body and less in her left body. Painful spasms had disappeared.

CONCLUSION

We propose continuous baclofen intrathecal infusion pump for patients with severe torsion dystonia that not response to ordinal treatment.

[Chemical composition and digestibility of the protein of 20 ecotypes of Pijiguao (Bactris gassipaes) of the Venezuelan Amazon]

Precooked flour (80 degrees C x 3 hours) from the pulp of 20 ecotypes of Pijiguao cultivated in the Amazon area of Venezuela and dried at 80 degrees C for 3 hours was manufactured for the purpose of developing an alternative method of conservation of the fruit for human consumption and for the purpose of contributing to the study of the germoplasm through the assessment of its chemical characterization by applying the AOAC methods. The results showed a wide statistical variability (p < 0.05) among the ecotypes in relation to the fat content (5.13%-17.30%), protein content (5.00%-8.30%), starch content (29.13%-56.40%), and dietetic fiber content (8.10%-21.00%). Likewise, significant differences in the carotenoid content (3.46-40.06 mg/100 g) and the vitamin C content (6.60 to 51.60 mg/100 g) were also detected. The digestibility "in vitro" of the protein was high (88.10%-91.90%). In addition color was analyzed in a tristimulus color meter and the data varied between L = 65.07 to 81.84; a = 0.18 to 13.96 y b = 18.30 to 38.82. Orange, yellow, and beige were observed Pijiguao precooked flour is a potential source of dietetic carotenoids, vitamin C, fat, and starch.

Evaluation of institutional cancer registries in Colombia

The four primary objectives of this descriptive study were to: 1) design a quality-measurement instrument for institutional cancer registries (ICRs), 2) evaluate the existing ICRs in Colombia with the designed instrument, 3) categorize the different registries according to their quality and prioritize efforts that will efficiently promote better registries with the limited resources available, and 4) determine the institution with the greatest likelihood of successfully establishing Colombia's second population-based cancer registry. In 1990 the National Cancer Institute of Colombia developed 13 institution-based cancer registries in different Colombian cities in order to promote the collection of data from a large group of cancer diagnostic and treatment centers. During the first half of 1997, this evaluation reviewed 12 registries; one of the original 13 no longer existed. All of the Colombian institutions (hospitals) that maintain institution-based cancer registries were included in the study. At each institution, a brief survey was administered to the hospital director, the registry coordinator, and the registrar (data manager). Researchers investigated the institutions by looking at six domains that are in standard use internationally. Within each domain, questions were developed and selected through the Delphi method. Each domain and each question were assigned weights through a consensus process. In most cases, two interviewers went to each site to collect the information. The university hospitals in Cali, Pereira, and Medellín had substantially higher scores, reflecting a good level of performance. Four of the 12 institutions had almost no cancer registry work going on. Five of the 12 hospital directors considered that the information provided by the cancer registries influenced their administrative decisions. Three of the registries had patient survival data. Four of the institutions allocated specific resources to operate their cancer registries; in the other 8 hospitals there was no clear budget allocation. Seven of the hospital directors could not identify five or more objectives of a cancer registry. Data management was usually poor and resources insufficient at most of the institutions. In summary, the cancer registry system in Colombia varies greatly from institution to institution. A few of the hospitals do a good job while others have neglected the registries. The high, identical total scores for Pereira and Medellín suggest they would be good locations to establish new population-based cancer registries similar to the existing one in Cali. However, the overall characteristics in Pereira may provide a more appropriate environment for the second registry, with Medellín as an alternative.

[Sotos syndrome associated with focal dystonia]

INTRODUCTION

Sotos syndrome is a form of infantile gigantism characterized by excessive body size from the time of birth, particular facies, acromegalic changes and signs of non-progressive cerebral involvement. The etiology is unknown. Diagnosis is based on somatometric data and the particular phenotype traits. Biochemical and endocrine studies are normal. Torticollis is a focal dystonia and therefore more common in adults.

CLINICAL CASE

A 20 year old woman with macrosomic features since birth presented with: weight 104 kg, height 182 cm; prognathism, hypertelorism, a broad over hanging forehead with a high hair line; large ears, hands and feet; torticollis towards the right with elevation and anteroversion of the right shoulder which caused symptomatic scoliosis. She was bradypsychic and rather slow in speech. The complementary tests done (cerebral and cervical CT and MR, bone gammography, evoked potentials, EMG-ENG, sural nerve biopsy, biopsy of skin and muscle, EEG and hormone and biochemistry studies) were normal. The torticollis was treated with botulinus toxin and improved considerably, as did the scoliosis.

CONCLUSIONS

To date, dystonia has not been described in association with Sotos syndrome. This may be a causal association, or even perhaps hereditary, since the patient's mother had dystonia (in the form of blepharospasm).

Fine needle aspiration of thyroid nodules in a rural setting

PURPOSE

The purpose of this study was to evaluate the applicability of fine needle aspiration biopsy (FNAB) of thyroid nodules in rural practices with smaller patient numbers, to assess the effect of these numbers on the results, and to establish the level of accuracy of the procedure in this setting.

PATIENTS AND METHODS

We retrieved all thyroid FNAB reports identified as being performed by a single practitioner in a referral endocrine practice in Rapid City, South Dakota, between September 30, 1987, and September 30, 1991. Biopsy results are separated by year to establish correlations with the number of biopsies and outcomes. Follow-up pathology reports were obtained for all patients known to have undergone surgery.

RESULTS

A total of 189 FNABs in 165 patients were available for review from a 4-year period. The number of FNABs increased progressively from 28 per year to 65 per year during the 4-year course of the study. The incidence of inadequate specimens decreased inversely from 18% to 6% with the increase in the number of FNABs. The percentage of surgical interventions in which malignancy was found increased from 23% to 50% over the same period. Analysis of the results suggests that accuracy and specificity are comparable to results from larger centers.

CONCLUSIONS

FNAB of thyroid nodules can substantially reduce surgical intervention and increase the yield of malignancy without excessive loss of accuracy even in rural areas with small numbers of patients. Improved results as the number of biopsies increased to 50 or more per year suggest benefits from concentrating biopsies with as few operators as practical.

Candida arthritis in adult patients who are not intravenous drug addicts: report of three cases and review of the literature

Candida species are an uncommon cause of infectious arthritis, although the frequency has increased during recent years. Three cases of septic arthritis caused by Candida species are reported, and the literature is reviewed. The first patient developed a popliteal cyst infected by Candida albicans after multiple intravenous antibiotic treatments. The second patient had acute myelogenous leukemia and experienced knee arthritis after chemotherapy, and the third suffered oligoarthritis after a second heart transplantation. All patients received treatment with a standard dose of intravenous amphotericin B. Responses were achieved only in the first two cases; the third patient died despite therapy. Thirty-six previously reported Candida arthritis cases are reviewed, and epidemiologic, diagnostic, therapeutic, and prognostic features are analyzed. Cases are divided into two categories: direct inoculation of fungus and hematogenously disseminated disease; these two categories are compared in terms of sex, age, pathogen species, treatment, and survival. Arthritis induced through direct inoculation of fungus is seen in older individuals, is more frequently produced by species other than C albicans (Candida parapsilosis especially), and has a better prognosis than arthritis caused by disseminated candidiasis. Arthritis can be resolved even in the persistence of the systemic disease. It is believed that the first case of Baker's cyst infected by C albicans and the first case of Candida arthritis in a heart transplant patient are reported here.

Floor/shoe slip resistance measurement

A variety of slip measurement devices exist that provide estimates of both static and dynamic coefficient-of-friction (COF) values between one's shoes and the floor. Unfortunately, different shoe sole/heel materials, floor conditions, and contaminants will affect the tests in ways that result in widely varying COF estimates. This paper reviews the basic physics of such tests and describes a set of experiments to determine the static and dynamic COF values under operating conditions known to exist in different jobs. The results define a set of conditions wherein low (hazardous) COF values would exist (e.g., hard Neolite shoe material in contact with a wet, smooth walking surface). The results also question the use of light-load testing devices and static and slow speed reference COF values in the literature.

Selective expansion of T cells bearing the gamma/delta receptor and expressing an unusual repertoire in the synovial membrane of patients with rheumatoid arthritis

In a study of 7 patients with rheumatoid arthritis (RA), we characterized the T cell population present in the synovial membrane, thought to be the location where T cells trigger the disease. Synovial membrane lymphocytes from the RA patients were found to have a selective expansion of gamma/delta T cells (8.8% in synovial membrane versus 4% in peripheral blood). Expansion of the gamma/delta T cell subset was not found in the synovial membrane of patients with osteoarthritis. We characterized the gamma/delta T cell repertoire using monoclonal antibodies Ti gamma A, BB3, and delta TCS1, which recognize the gene products encoded by V gamma 9, V delta 2, and V delta 1-J delta 1, respectively. The majority of the synovial gamma/delta T cells did not express the repertoire encoded by these genes, which is found in nearly 100% of the peripheral blood gamma/delta T cells of healthy volunteer donors and in the thymus at early stages of development. We conclude that the synovial membrane of patients with RA displays a selective expansion of a specific population of gamma/delta T cells expressing a clonotypic receptor not yet serologically defined, which might be implicated in the development of the disease.

Enterotoxins and adhesins of enterotoxigenic Escherichia coli: are they risk factors for acute diarrhea in the community?

A cohort of 228 Mexican children less than 5 years old was followed during the enterotoxigenic Escherichia coli(ETEC) season. The incidence of ETEC diarrhea-associated and asymptomatic infections was determined, and E. coli strains isolated from stool samples were tested for heat-labile and heat-stable toxins and for expression of colonization factor antigens (CFA). Of the children, 61% had at least one ETEC infection. Children with ETEC isolated from stools were more likely to have diarrhea than were ETEC-free age-matched control children (odds ratio [OR] = 4.5; 95% confidence interval [CI] = 2.9-7.0). Strains carrying CFA/IV, CFA/I, or CFA/II were found in 23%, 18%, and 5% of ETEC infections, respectively. The risk of having diarrhea associated with a CFA-expressing versus a CFA-negative ETEC strain was the same (age-adjusted OR = 0.8; 95% CI = 0.4-1.6). These data should be considered in the development of a diarrhea vaccine containing only CFAs.

Salt-sensitive blood pressure and exaggerated vascular reactivity in the hypertension of diabetes mellitus

PURPOSE

This study evaluates the effects of dietary salt restriction and loading on blood pressure in normotensive and hypertensive patients with non-insulin-dependent diabetes mellitus (NIDDM). Salt sensitivity of blood pressure responses is compared to vascular reactivity to infused angiotensin II on the two sodium diets.

PATIENTS AND METHODS

We studied 19 patients with NIDDM (seven normotensive, 12 hypertensive) and seven nondiabetic control subjects under metabolic balance after 6 days on a constant low- (20 mEq) sodium diet and again after 6 days on a high- (250 mEq) sodium diet. Salt sensitivity of blood pressure was determined by the increment in integrated 24-hour blood pressure values on changing from the low- to the high-sodium diet. Blood pressure and plasma aldosterone responses to a graded-dose infusion of angiotensin II were also examined on both sodium diets.

RESULTS

Eight of 12 hypertensive patients with NIDDM displayed salt-sensitive blood pressure responses, whereas none of the normotensive patients with NIDDM or control subjects were salt-sensitive. Patients with NIDDM also had augmented blood pressure responses to infused angiotensin II on both sodium diets when compared to control subjects. Whereas controls had reduced vascular responses to angiotensin II on the low-sodium diet, these responses were not decreased in patients with NIDDM. Patients with NIDDM also retained more sodium on the high-sodium diet than did the control subjects.

CONCLUSION

Hypertension in patients with NIDDM is frequently salt-sensitive, which may be due to sodium retention and enhanced vascular reactivity to angiotensin II. Since sodium restriction does not normally reduce vascular reactivity to angiotensin II in NIDDM, salt-restricted diets may be less effective in blood pressure control in hypertensive NIDDM.

Renin regulation in type II diabetes mellitus: influence of dietary sodium

Numerous abnormalities in the renin-angiotensin system have been described in diabetes mellitus. Plasma renin activity (PRA) has been noted to be low, normal, and high in diabetic patients; these variable results may be explained by differences in patient selection and standardization of study conditions. We evaluated PRA and inactive renin responses in Type II normotensive (n = 7) and hypertensive (n = 12) diabetic patients specifically selected for no or minimal evidence (background retinopathy) for microvascular complications. Patients were studied in a metabolic ward after 7 days on a constant low sodium (20 meq/day) and 7 days on a high sodium (250 meq/day) diet. Nondiabetic control subjects (n = 7) were evaluated under similar conditions. On low sodium intake, mean PRA levels were significantly reduced in the hypertensive diabetic group, but were not different between the control and normotensive diabetic groups. Hypertensive diabetic patients on high sodium intake also had greater reductions in PRA responses compared with the other study groups. In general, diabetic subjects on high sodium intake excreted less sodium and had more cumulative sodium retention than control subjects. Levels of inactive renin were not significantly different between the normotensive and hypertensive diabetic patients and were comparable with the levels in control subjects. Inactive renin levels changed in a similar direction and magnitude as PRA in response to sodium intake and posture in the three study groups. Infusion of angiotensin II led to comparable reductions in PRA in both diabetic groups and in the control group, suggesting an intact short feedback loop control.(ABSTRACT TRUNCATED AT 250 WORDS)

Respirator protection factors: Part II-protection factors of supplied-air respirators

Protection Factors provided by 25 NIOSH approved supplied-air respirators were determined while the devices were worn by a panel of test subjects anthropometrically selected to represent adult facial sizes. Polydispersed DOP aerosol was used for respirator fit tests on continuous flow, demand, and pressure-demand respirators. Based on facepiece leakage measurements it appears that demand-type respirators should neither be used nor approved. The highest level of protection was provided by pressure-demand devices.

[Mediastinal ganglioneuroma (author's transl)]

One case of a mediastinal ganglioneuroma in a two years old girl is reported. The radiologic features of the tumor are discussed, concerning to the paradoxical tumor volume and its placement. Clinical, radiological and therapeutic considerations about this condition are made.