Bounded survival

The useful and flexible “generic” family of parametric survival functions has been extended to cover the case of a hypothesized bound on the lifespan. The resulting model can be considered to be analogous to a simple system of three chemical reactions where survivors are lost, and where hazard (risk) and senescence are increased. Tables of one, two, and three parameter special cases, including single hit, Gompertz, Weibull, extreme value, and Burr functions, are presented. An application to a published life table is briefly discussed.     

Analysis of survival data with cross-effects of survival functions

We present a model and semiparametric estimation procedures for analysis of survival data with cross-effects (CE) of survival functions. Finite sample properties of the estimators are analyzed by simulation. A goodness-of-fit test for the proportional hazards model against the CE model is proposed. The well known data concerning effects of chemotherapy and radiotherapy on the survival times of gastric cancer patients is analyzed as an example.     

Early Bacillus anthracis-macrophage interactions: intracellular survival survival and escape

This study describes early intracellular events occurring during the establishment phase of Bacillus anthracis infections. Anthrax infections are initiated by dormant endospores gaining access to the mammalian host and becoming engulfed by regional macrophages (Mφ). During systemic anthrax, late stage events include vegetative growth in the blood to very high titres and the synthesis of the anthrax exotoxin complex, which causes disease symptoms and death. Experiments focus on the early events occurring during the first few hours of the B. anthracis infectious cycle, from endospore germination up to and including release of the vegetative cell from phagocytes. We found that newly vegetative bacilli escape from the phagocytic vesicles of cultured Mφ and replicate within the cytoplasm of these cells. Release from the Mφ occurs 4–6 h after endospore phagocytosis, timing that correlates with anthrax infection of test animals. Genetic analysis from this study indicates that the toxin plasmid pXO1 is required for release from the Mφ, whereas the capsule plasmid pXO2 is not. The transactivator atxA , located on pXO1, is also found to be essential for release, but the toxin genes themselves are not required. This suggests that Mφ release of anthrax bacilli is atxA regulated. The putative 'escape' genes may be located on the chromosome and/or on pXO1.     

Apoptosis and survival

The term apoptosis first appeared in the biomedical literature in 1972, to delineate a structurally distinctive mode of cell death responsible for cell loss within living tissues. The cardinal morphological features are cell shrinkage, accompanied by transient but violent bubbling and blebbing from the surface, and culminating in separation of the cell into a cluster of membrane-bounded bodies. Changes in several cell surface molecules also ensure that, in tissues, apoptotic cells are immediately recognised and phagocytosed by their neighbours. However, it is important to note that apoptosis is only one form of cell death and the particular death pathway that is the most important determinant for cancer therapy is not necessarily that which has the fastest kinetics, as is the bias in many laboratories, but rather that which displays the most sensitive dose-response relationship.     

Mutation for survival

Adaptive mutations appear in response to selection. In the best-studied system, the two most controversial issues were resolved this year. The mutations are neither Lamarckian nor a peculiarity of bacterial sex, as had been suggested. They occur genome-wide in a hypermutable subpopulation of stressed cells. Genomic ‘hot’ and ‘cold’ regions may explain previous failures to detect similar mutations in other systems and at other sites. Stationary phase specific limitation of mismatch repair has also been discovered.     

Modeling survival of experimentally virus-infected laboratory animals--exploration of the survival diagram

In a recent paper (Sühnel & Veckenstedt, 1989, J. theor. Biol. 137, 27) we have proposed a new method of plotting survival data from experimentally virus-infected laboratory animals; the survival diagram. In this diagram two experiments, for which the mean number of virions inoculated is kept fixed but other parameters may vary, are compared. The variations in two basic quantities of survival analysis are simultaneously displayed: the standard mean survival time and the relative mean challenge virus dose, which is via a dose-response relation interrelated with the fraction of animals dying. It is analyzed in which manner variations in the kinetic parameters and the critical virus level necessary to produce a particular effect influence the location of the points of comparison in the survival diagram. The analysis presented is a prerequisite for further applications of this diagram and of the underlying mathematical model.     

Immune response and survival

Immune responses have evolved to defend hosts efficiently against the debilitating effects of parasites on host fitness. However, there are relatively few studies of the efficiency of the immune system in terms of providing hosts with an ability to defend themselves against parasitism. A meta-analysis of the literature on survival of birds in relation to non-specific immune response to challenge with an antigen or other measures of immune function demonstrated a mean effect adjusted for sample size of 0.43 across 12 studies. This observation shows that relatively simple estimates of non-specific immune responses often reliably predict a large and significant amount of variation in survivorship.     

Infant survival in prematurity

Reduction of neonatal mortality and the rate of stillbirth may be expected from improved management of spontaneous labor and delivery.Neither roentgenographic measurement nor the inception of fetal movement or heartbeat nor any other single test is an index of fetal maturity; all must be considered together. Prenatal care, particularly supplemented diet, will help to avoid premature delivery, or at least to prolong pregnancy; since the fetus undergoes accelerated growth during the last weeks of pregnancy, even slight extension of gestation increases the chances for survival. Analgesia in the first stage of premature labor is contraindicated. Only low spinal anesthesia and other types of conduction anesthesia should be employed for later stages. The fetal membranes should be preserved as long as possible, but premature rupture does not call for immediate termination of pregnancy. Deep episiotomy and prophylactic outlet forceps are routinely employed to hasten the second stage of premature delivery and to protect the immature fetus. Breech presentation is managed by unassisted expulsion or by forceps extraction of the head. The umbilical cord is not immediately severed on delivery; administration of oxytocic drugs after the second stage of labor, combined with gentle stripping of the cord, results in rapid transfer of increased amount of placental blood. The airways of the infant should be immediately cleared. Artificial respiration may be necessary and it must be gentle.All premature infants should receive supplementary oxygen to render breathing regular and more efficient. They should be insulated immediately in controlled temperature and humidity, and they should be handled little.     

Intracellular survival by Chlamydia

Chlamydiae are obligate intracellular bacterial pathogens whose entry into mucosal epithelial cells is required for intracellular survival and subsequent growth. After a seemingly stealthy entry, chlamydiae quickly modify their vacuole (i) for exit from the endosomal pathway to the exocytic pathway and (ii) to permit fusion with intercepted endoplasmic reticulum- and Golgi-derived vesicles carrying glycerophospholipids and sphingolipids for chlamydiae-containing vacuole membrane expansion. Chlamydiae possess novel hollow proteinaceous structures, termed projections, which they use to pierce the inclusion membrane, possibly to acquire from the epithelial cytoplasm nutrients they cannot synthesize; whether or not these truncated flagellar-like structures serve a dual exchange function for secretion of molecules to programme host cell signalling is unknown. Despite the accumulation of some 500–1000 progeny in the enormously enlarged inclusion, host cell function is surprisingly little disrupted, and progeny escape can be unobtrusive. This elegant adaptive pathogen strategy, which leads to silent, chronic human infection, is fascinating from a cellular microbiology perspective.