Plague Meningitis—A Retrospective Analysis of Cases Reported in the United States, 1970-1979

Meningitis caused by Yersinia pestis developed in 6 (6%) of a total of 105 patients with plague reported to the Centers for Disease Control from 1970 to 1979. Five of the six cases occurred in children aged 10 to 15 years. All six patients received antibiotic therapy before meningitis developed, which appeared between the 9th and 14th days after the onset of acute illness in five of the six patients. There were no neurologic sequelae. The antigenic and biochemical profiles of the Y pestis strains isolated from cerebrospinal fluid in the meningitis cases did not differ from those of the Y pestis strains obtained from blood and bubo aspirates in the other 99 patients, and neither did in vitro studies suggest antibiotic resistance. While plague meningitis is an uncommon complication of acute plague infection, physicians in the western United States should be aware that it may develop as much as 14 days after antibiotic therapy for the acute plague infection has been initiated.     

Global Epidemiology

A total of 62,811 cases of the acquired immunodeficiency syndrome (AIDS) have been reported to the World Health Organization from throughout the world. Extensive epidemiologic studies have shown that human immunodeficiency virus (HIV) infections are transmitted by three routes: sexual, parenteral and perinatal. Three geographic patterns of transmission have been defined. In pattern I, transmission occurs predominantly among homosexual and bisexual men and urban intravenous drug abusers; transmission via blood products has been controlled; the male:female sex ratio is 10:1 or more; population HIV seroprevalence is low, and perinatal transmission is uncommon (for instance, United States, western Europe). In pattern II, transmission is predominantly heterosexual and perinatal; transmission via blood products exists but is being reduced; unsterile needles and other skin-piercing instruments cause some parenteral transmission (magnitude not known); the male:female sex ratio is 1:1, and population seroprevalence often exceeds 1% (central Africa, Haiti). In pattern III, AIDS cases are just being documented and are generally due to sexual exposure abroad or imported blood products (Middle East, Asia).     

Variation of lumbar spine stiffness with load

Mechanical studies of the Functional Spinal Unit (FSU) in-vitro have shown that the slopes of the load-displacement curves increase with load. This nonlinearity implies that the stiffness of the FSU is not constant over the range of physiologic loads, and that measurements obtained for FSU specimens through the application of individual loads cannot be summed to predict the response of the specimens to combined loads. Both experimental and analytical methods were developed in the present study to better quantify the nonlinear FSU load-displacement response and to calculate the coupled stiffness of FSU specimens at combined states of load reflecting in-vivo conditions. Results referenced to the center of the vertebral body indicate that lumbar FSU specimens are stiffer in flexion than in extension, and that FSU specimens loaded in flexion are stiffer at high loads than at low loads. The importance of combined load testing and a nonlinear interpretation of load-displacement data is demonstrated.     

ARAGONITE CRYSTALS IN SPIROGYRA SP. (CHLOROPHYTA)

Intracellular crystals of aragonite have been identified by selected area electron diffraction (SAED) in a species of the freshwater filamentous alga Spirogyra from the Thames River, Ontario, Canada. The crystals are 2 to 24 μm in diameter, and characterized by a unique cross-shaped morphology, in which needle-like, or prismatic outgrowths develop from a common axis. Crystals may be dispersed throughout filaments, but tend to cluster as aggregates towards the centre .     

Effect of continuous infusion of a low dose of GnRH antagonist on serum LH and testosterone concentrations, spermatogenesis and semen quality in the rhesus monkey (Macaca mulatta)

Treatment of 4 adult male rhesus monkeys for 8-12 months with 100-400 micrograms of a GnRH antagonist/day by means of using osmotic minipumps led to suppressed serum concentrations of LH and testosterone followed by various degrees of recovery toward pretreatment values. The serum LH response to a challenge of native GnRH was reduced by 30-75% during antagonist treatment. The serum testosterone response to GnRH was exaggerated above the response in the pretreatment period, suggesting hypersensitivity of the testis to gonadotrophin. Antagonist administration under these conditions did not alter body weight or abolish ejaculatory response. Antagonist infusion caused a 96% decrease in sperm counts. Spermatozoa recovered during the final month of antagonist treatment showed a reduced ability to penetrate denuded hamster ova. Testicular biopsies performed at the end of antagonist treatment revealed persistent spermatogenesis. However, the cellularity of the seminiferous tubules was decreased below that of pretreatment biopsies. The results of this study suggest that the amount of testosterone needed to maintain normal spermatogenesis is greater than that needed to maintain electroejaculatory response in monkeys.     

Membrane penetration of bovine factor V and Va detected by labeling with 5-iodonaphthalene-1-azide

The membrane-binding properties of Factor V and Factor Va were investigated using the lipophyllic, photoactivable probe 5-[125I]iodonaphthalene-1-azide. In the presence of vesicles composed of 75% phosphatidylcholine and 25% phosphatidylserine, both Factor V and Va were found to be labeled by the probe. The label was almost exclusively localized to the carboxyl-terminal-derived component E of Factor Va. The results are consistent with the interpretation that component E is the membrane binding subunit of Factor Va and that the interaction between Factor V or Factor Va and the membrane involves the penetration of the protein into the lipid bilayer.     

Inactivation of factor Va by plasmin

The inactivation of Factor Va by plasmin was studied in the presence and absence of phospholipid vesicles and calcium ions. The cleavage patterns of bovine Factor Va and its isolated subunits were analyzed using polyacrylamide gel electrophoresis, and the progress of inactivation was monitored by clotting assays and measurements of prothrombin activation using 5-dimethylaminonaphthalene-1-sulfonylarginine-N-(3-ethyl-1,5-penta nediyl)amide. In addition, the ability of prothrombin and Factor Xa to protect Factor Va from inactivation by human plasmin was examined. The data presented indicate that the cofactor Factor Va is inactivated rapidly upon its interaction with human plasmin. The rate of inactivation is significantly enhanced in the presence of phospholipid vesicles, suggesting that the inactivation process is a membrane-bound phenomenon. The isolated D component (heavy chain of factor Va) was found to be slowly degraded by human plasmin, giving rise to cleavage products different from those obtained with activated protein C and Factor Xa. However, the 48- and 30-kDa fragments obtained from human plasmin degradation of component E (light chain of Factor Va) appear to be similar to those obtained following the proteolysis of the same subunit by activated protein C and Factor Xa.     

Cytotoxic T lymphocytes from mice with soluble class I Q10 molecules in their serum are not tolerant to membrane-bound Q10

Q10 is a class I Qa-2 region-encoded molecule that is secreted by the liver and present in serum at high concentrations (about 10 to 60 micrograms/ml) in most strains of mice. The amino terminal portion of this molecule can also be expressed as an integral membrane protein by splicing the 5' end of the Q10 gene to the 3' end of H-2Ld and transfecting the hybrid gene into murine L cells. Because CTL primarily recognize polymorphic determinants controlled by the alpha 1 and alpha 2 domains of class I molecules and because the Q10d/Ld product expressed by transfected L cells includes the alpha 1 and alpha 2 domains of Q10d, we could address whether mice bearing serum Q10 were tolerant to this molecule at the CTL level. The results of these experiments demonstrate that Q10+ mice are able to generate H-2-unrestricted CTL activity against Q10d expressed on transfected L cells, and this response was not inhibitable by the addition of Q10-containing normal mouse serum. It is unlikely that this CTL activity is due to possible polymorphic differences in Q10 alleles, since semisyngeneic BALB/c (H-2d) mice, from which the Q10d hybrid gene construct was derived, are able to generate anti-Q10d effector cells. The Q10d molecule was shown to cross-react with H-2Ld, lending support to the concept that Qa genes can serve as donors for polymorphic sequences found in H-2K, -D, and -L. That mice can generate anti-Q10 CTL activity suggests that this soluble class I protein does not act as a toleragen for these cells. The implications of these findings for an understanding of self-tolerance are discussed.     

Demographic Trends of Aging — Application to Gerodontology1

Aging of the global world population both in developed and developing countries, an unbalanced male-female ratio within this elderly population, increasing populations – including elderly – within urban areas, all will have a marked effect on the practice of dentistry. Furthermore, major epidemiological changes occurring in the dental field, including an increasing dentition life expectancy, increasing root caries prevalence, decreasing coronal caries rates in children, and the relative increase in the prevalence of periodontal problems will have further impact on the dental care system. Major changes need to be anticipated both at the level of the care provider, including the dentist, the hygienist and the dental assistant, and at the level of the potential patient, especially among the geriatric population, if the profession is to be prepared to adequately address these issues.