Diagnosis of Pneumocystis carinii pneumonia

Pneumocystis carinii is the prime opportunistic pathogen of our time, the leading cause of fatal pneumonia in the increasing number of immunosuppressed subjects encountered on oncology and transplant programmes' and in subjects with the acquired immuno-deficiency syndrome (AIDS).     

Pneumocystis carinii shows DNA homology with the ustomycetous red yeast fungi

Pneumocystis carinii causes life-threatening pneumonia in T-lymphocyte-immunodeficient subjects in transplant and oncology units or with acquired immune deficiency syndrome (AIDS). Recent DNA homology studies show P. carinii to be a fungus. To investigate the biology and epidemiology of this parasite further, we elected to determine for it a more precise taxonomic assignment within the fungal kingdom. We screened a wide range of organisms representing the major orders of fungi using DNA amplification and subsequently sequenced a portion of the mitochondrial gene encoding the large subunit ribosomal RNA. Our data show that the opportunistic pulmonary pathogen P. carinii is closely related to the ustomycetous red yeast fungi, a group which includes organisms that are extensively distributed throughout the environment and which release many widely dispersed airborne spores.     

The ecology, morphology and behaviour of Bakerdania elliptica (Acari: Prostigmata: Pygmephoridae), a mite associated with terrestrial isopods

In deciduous woodlands near to Bristol, South-west England, about one in ten specimens of the woodlouse Oniscus asellus (L.) are infested with Bakerdania elliptica (Krczal, 1959), a small pygmephorid mite of about 200 pm in length. Woodlice in the field rarely carry more than three mites, which are usually attached to the mid or lateral regions of the sixth and seventh pereonites on the ventral surface of the isopod. These 'favoured sites' correspond to regions of the exoskeleton of the woodlouse which are free from abrasion as they move through leaf litter. Mites removed from these areas and replaced on the first pereonite return to a favoured site, usually within 30 min. During this process they exhibit four distinct types of behaviour.]
Uninfested specimens of Oniscus usellus maintained in laboratory tanks on leaf litter from their 'own' site all become infested with mites within a week. The number of mites on the isopods increases rapidly under these conditions. After six weeks, each individual carries a mean of about 50 mites. The level of infestation is subsequently stable, probably due to saturation of favoured sites, since large numbers of unattached mites can be found in the leaf litter during this period.
Studies by light microscopy and scanning electron microscopy have shown that Bakerdania elliptica does not feed while attached to the cuticle of Oniscus asellus , and that all attached mites are females. Males are extremely rare and occur only in leaf litter. These observations suggest that the relationship between Bakerdania elliptica and Oniscus asellus is one of phoresy and that female mites use woodlice as an aid to dispersal during their life cycle.     

Efficacy of facemask resuscitation at birth.

The efficacy of facemask resuscitation was assessed by measuring the expiratory tidal volume during the first three inflations in nine babies with birth asphyxia and comparing the results with those obtained in a further nine babies resuscitated after endotracheal intubation. The facemask system was relatively inefficient, with tidal exchange less than one third of that seen after intubation and rarely sufficient to produce adequate alveolar ventilation. Successful resuscitation depended on stimulating the baby to make his own respiratory efforts.     

Variation in response to cytotoxicity of cigarette smoke.

The cytotoxic effect of cigarette smoke condensate on human polymorphs was investigated in vitro by the method of vital dye exclusion. Exposure to 1/800 of the smoke from one high-tar cigarette killed a detectable proportion of a population of 10(6) cells. The response among the cells from 40 healthy people varied widely, the percentage of dead cells ranging from 3% to 66% and from 17% to 87% at exposure levels of 125 micrograms and 250 micrograms cigarette smoke condensate respectively. Differences in individuals'' responses were reproducible and unrelated to age or sex or smoking habit. The cells from 10 patients with irreversible obstructive airways disease and probable emphysema were significantly more sensitive than those from 10 patients with no respiratory disability matched for age and smoking habits. Genetically influenced variation in cellular response to cytotoxicity may be an important determinant of the risk of developing emphysema among smokers.     

RhoJ modulates melanoma invasion by altering actin cytoskeletal dynamics

Rho family GTPases regulate diverse processes in human melanoma ranging from tumor formation to metastasis and chemoresistance. In this study, a combination of in vitro and in vivo approaches was utilized to determine whether RHOJ, a CDC42 homologue that regulates melanoma chemoresistance, also controls melanoma migration. Depletion or overexpression of RHOJ altered cellular morphology, implicating a role for RHOJ in modulating actin cytoskeletal dynamics. RHOJ depletion inhibited melanoma cell migration and invasion in vitro and melanoma tumor growth and lymphatic spread in mice. Molecular studies revealed that RHOJ alters actin cytoskeletal dynamics by inducing the phosphorylation of LIMK, cofilin, and p41‐ARC (ARP2/3 complex subunit) in a PAK1‐dependent manner in vitro and in tumor xenografts. Taken together, these observations identify RHOJ as a melanoma linchpin determinant that regulates both actin cytoskeletal dynamics and chemoresistance by activating PAK1.     

Characterization of Early Disease Status in Treatment-Naive Male Paediatric Patients with Fabry Disease Enrolled in a Randomized Clinical Trial

Trial Design

This analysis characterizes the degree of early organ involvement in a cohort of oligo-symptomatic untreated young patients with Fabry disease enrolled in an ongoing randomized, open-label, parallel-group, phase 3B clinical trial.

Methods

Males aged 5–18 years with complete α-galactosidase A deficiency, without symptoms of major organ damage, were enrolled in a phase 3B trial evaluating two doses of agalsidase beta. Baseline disease characteristics of 31 eligible patients (median age 12 years) were studied, including cellular globotriaosylceramide (GL-3) accumulation in skin (n = 31) and kidney biopsy (n = 6; median age 15 years; range 13–17 years), renal function, and glycolipid levels (plasma, urine).

Results

Plasma and urinary GL-3 levels were abnormal in 25 of 30 and 31 of 31 patients, respectively. Plasma lyso-GL-3 was elevated in all patients. GL-3 accumulation was documented in superficial skin capillary endothelial cells (23/31 patients) and deep vessel endothelial cells (23/29 patients). The mean glomerular filtration rate (GFR), measured by plasma disappearance of iohexol, was 118.1 mL/min/1.73 m² (range 90.4–161.0 mL/min/1.73 m²) and the median urinary albumin/creatinine ratio was 10 mg/g (range 4.0–27.0 mg/g). On electron microscopy, renal biopsy revealed GL-3 accumulation in all glomerular cell types (podocytes and parietal, endothelial, and mesangial cells), as well as in peritubular capillary and non-capillary endothelial, interstitial, vascular smooth muscle, and distal tubules/collecting duct cells. Lesions indicative of early Fabry arteriopathy and segmental effacement of podocyte foot processes were found in all 6 patients.

Conclusions

These data reveal that in this small cohort of children with Fabry disease, histological evidence of GL-3 accumulation, and cellular and vascular injury are present in renal tissues at very early stages of the disease, and are noted before onset of microalbuminuria and development of clinically significant renal events (e.g. reduced GFR). These data give additional support to the consideration of early initiation of enzyme replacement therapy, potentially improving long-term outcome.

Trial Registration

ClinicalTrials.gov NCT00701415     

Thermal acclimation,heat shock and photoperiod: Do these factors interplay in the adaptive responses of crab neuromuscular systems to temperature?

Evidence is reviewed demonstrating that the adaptive responses to temperature made by the walking leg neuromuscular system of crabs (Carcinus maenas) are in response to local temperature and not in response to hierarchical influences by the CNS and hormonal systems.     

Negative association between asthma and variants of CC16(CC10) on chromosome 11q13 in British and Japanese populations

The gene encoding Clara cell-derived inflammatory molecule CC16 has been cited as a candidate gene for atopic asthma on chromosome 11q13. A genetic association study was performed with variants of the CC16 gene on chromosome 11q13 in relation to asthma in British (n=275) and Japanese (n=300) populations. No significant association was found between asthma and CC16 genotypes, irrespective of atopic status in these two populations. These data suggest that CC16 might not be the major locus for asthma on 11q13. Received: 22 December 1997 / Accepted: 9 February 1998