Transverse myelitis. Comparison with spinal cord presentations of multiple sclerosis

This study reports results 1 year after treatment for 77 obese women who had been treated for 48 weeks by diet combined with supervised (a) aerobic exercise, (b) strength training, (c) aerobic plus strength training combined, or (d) no exercise. Mean (+/- SD) end-of-treatment weight losses for the 4 conditions ranged from 13.5 +/- 9.1 kg to 17.3 +/- 10.3 kg, but there were no statistically significant differences among groups. Participants in all 4 conditions regained approximately 35% to 55% of their weight loss in the year after treatment; again, there were no significant differences among groups. Participants, however, who reported exercising regularly in the 4 months preceding the follow-up assessment regained significantly less weight than did nonexercisers.     

CD4(+) T-lymphocyte and immunoglobulin G2 responses in calves immunized with Anaplasma marginale outer membranes and protected against homologous challenge

Protective immunity against the ehrlichial pathogen Anaplasma marginale has been hypothesized to require induction of immunoglobulin G2 (IgG2) antibody against outer membrane protein epitopes and coordinated activation of macrophages for phagocytosis and killing. In the present study, cell-mediated immune responses, including induction of IgG isotype switching, were characterized in calves immunized with purified outer membranes of the Florida strain of A. marginale. Importantly, these calves were subsequently shown to be protected upon experimental challenge with the Florida strain, and calves which developed the highest IgG2 titers were completely protected against infection. Peripheral blood mononuclear cells (PBMC) obtained after immunization proliferated strongly in response to both whole A. marginale homogenates and purified outer membranes, and this responsiveness persisted until the time of challenge. Responding cells were shown to be CD4(+) T cells, and CD4(+) T-cell lines cultured for 2 to 4 weeks also proliferated specifically in response to A. marginale and produced high titers of gamma interferon. The helper T-cell response included recognition of conserved epitopes, as PBMC proliferation was stimulated by the homologous Florida strain, four genetically distinct A. marginale strains, and Anaplasma ovis. The outer membrane proteins stimulating the PBMC responses in protected calves included major surface proteins (MSPs) MSP-1, MSP-2, and MSP-3, which were previously shown to induce partial protection against infection. These studies demonstrate, for the first time, potent helper T-cell responses in cattle protectively immunized with outer membranes against A. marginale challenge and identify three MSPs that are recognized by immune T cells. These experiments provide the basis for subsequent identification of the helper T-cell epitopes on MSP-1, MSP-2, and MSP-3 that are needed to evoke anamnestic antibody and effector T-cell responses elicited by protein or nucleic acid immunization.     

The antidyslipoproteinemic activity of ufibrate in patients with non-insulin-dependent diabetes mellitus

Ufibrate (150 mg daily) was found to have a beneficial effect on main parameters characterizing lipid metabolism, with no effect being exerted on carbohydrate metabolism, as evidenced by three months' follow-up of 24 patients aged 42 to 65 presenting with insulin-nondependent type II diabetes mellitus and hyperlipidemia. Ufibrate appeared to be a most efficacious long-term drug treatment option, particularly so in those patients presenting with initially high blood levels of a great many of lipid fractions.     

Evaluation of antibodies reactive with Campylobacter jejuni in Egyptian diarrhea patients

Penis calcinosis is a rare pathology and only two previous cases have been reported in literature. We describe the clinicopathologic features of a case of nodular foreskin calcinosis in a 25-year-old man. The patient's history resulted negative for local trauma, inflammatory disorders or metabolic diseases. The mass measured up to 2 cm and was histologically constituted by multiple intradermic calcium deposits, whose deepest ones were surrounded by epithelioid histiocytes and multinucleated giant cells, with no evidence of any epithelial structures around none of them. These features were consistent with a non-metastatic calcinosis, likely idiopathic, even though also dystrophic calcinosis, observed at its end-stage, may show the same microscopic aspect. The exact idiopathic/dystrophic nosology is briefly discussed.     

Inadequate weight gain among pregnant adolescents: risk factors and relationship to infant birth weight

OBJECTIVE: Our purpose was to identify behavioral markers for inadequate weight gain (< 20 pounds) during pregnancy among adolescents < 18 years old. STUDY DESIGN: A total of 337 adolescents who were delivered of a term infant at our institution between March 10, 1992, and November 28, 1994 participated in this study. A comprehensive structured interview conducted at the first prenatal visit elicited demographic information and behavioral risk factors. Maternal weights, reproductive history, evidence of sexually transmitted disease, and infant birth weight were extracted from medical records. Logistic regression and chi 2 analyses compared characteristics and infant birth weights between those who gained < 20 pounds with those who gained > or = 20 pounds. RESULTS: A total of 11.6% (39/337) of the total sample gained < 20 pounds during the pregnancy. Adolescents who gained < 20 pounds compared with > or = 20 pounds were delivered of significantly lighter (2942 gm vs 3392 gm) infants and were more likely to be delivered of infants weighing < 2500 gm (13% vs < 1%). Stepwise logistic regression revealed that adolescents who were battered (odds ratio 5.3) or had a sexually transmitted disease (odds ratio 2.3) or an unplanned pregnancy (odds ratio 8.1) were at increased risk for insufficient weight gain during pregnancy. CONCLUSION: Our data suggest that behavioral risk factors are important in the identification of adolescents at greatest risk for inadequate weight gain. Early identification during pregnancy is essential to modify nutritional practices and thus minimize poor obstetric outcomes.     

Effects of a dietary mixture of meat and bone meal, feather meal, blood meal, and fish meal on nitrogen utilization in finishing Holstein steers

Our objective was to determine to what extent rate and efficiency of protein gain in finishing cattle can be enhanced by feeding an amino acid-balanced mixture of undegraded intake proteins. The Cornell Net Carbohydrate and Protein System (CNCPS) model was used to formulate a corn-based diet that would meet the rumen requirements for 410-kg large-framed steers with an estrogen implant and fed an ionophore. The CNCPS model was also used to formulate a highly undegradable intake protein (UIP) mixture from meat and bone meal, blood meal, fish meal, and hydrolyzed feather meal to provide the amino acids needed to supplement those derived from microbial protein to better meet amino acid requirements for growth. Four Holstein steers weighing 407 kg were offered a 90:10 concentrate-forage diet at hourly intervals at 95% of ad libitum intake. The steers were injected with 500 microg of estradiol-17beta at 12-h intervals to mimic the effects of an estrogenic implant. Treatments planned consisted of inclusion of the UIP mixture at 0, 2.5, 5, and 7.5% of the diet DM. Dry matter intake was fixed at 6.4 kg/d, and DM digestibility was not significantly affected by varying the amount of UIP addition. Apparent digestibility of N increased (P = .011) from 63.8 to 65.8, 70.7, and 71.5%, the amount of N absorbed increased (P = .001) from 73 to 84, 100, and 106 g/d, and N balance increased (P = .003) from 20 to 30, 33, and 39 g/d when UIP was fed at 0, 2.6, 5.2, and 7.8% of diet DM, respectively. The efficiency of N use increased 39.7%, and biological value increased 31.6% when the UIP mixture was added to the diet. Circulating concentrations of plasma urea N (PUN) were increased (P = .017) from 4.5 for the control diet to 5.7, 6.2, and 6.1 mg/dL when the UIP mixture was added at 2.6, 5.2, and 7.8%, respectively. Corresponding IGF-I concentrations were also increased from 491 to 558 and 624 ng/mL with 2.6 and 5.2% levels of UIP addition. Plasma glucose, NEFA, and insulin concentrations were not affected by feeding the UIP mix. The rate and efficiency of N use for growth improved with addition of an amino acid-balanced UIP mixture to the diet.     

Human herpesvirus 8 infection occurs following adolescence in the United States

Most recent evidence suggests that human herpesvirus 8 (HHV-8) infection is restricted to persons with Kaposi's sarcoma (KS) or to persons who may subsequently develop KS. To accurately determine the prevalence of infection in the United States, children and adults with AIDS were examined for evidence of HHV-8 infection to see whether HHV-8 (like other herpesviruses) would be readily detected in immunosuppressed persons. By use of nested polymerase chain reaction, DNA specific for HHV-8, Epstein-Barr virus, and cytomegalovirus was detected in blood leukocytes from 0, 26 (51%), and 9 (18%), respectively, of 51 children. Similarly, HHV-8-specific antibodies were not detected in analyses of sera from the children. By contrast, HHV-8 DNA was detected in 9 (27%) of 33 adult AIDS patients without KS. These findings suggest that the pattern of transmission of HHV-8 in the United States differs from that of other herpesviruses in that primary infection occurs predominantly in adults.     

Comparison of six-month outcome of coronary artery stenting in patients <65, 65-75, and >75 years of age

We studied 1,238 patients receiving 1,880 coronary stents. In-hospital outcomes were divided by age into <65 years (n = 747, group 1), 65 to 75 years (n = 326, group 2), and >75 years (n = 165, group 3). Procedural success was 97.2%, 95.1%, and 98.8% in groups 1, 2, and 3, respectively (p = NS). There was 1 death (group 1). Myocardial infarction occurred in 1.2%, 2.8%, and 1.8%, bypass surgery occurred in 0.9%, 1.8%, and 1.2%, and repeat balloon angioplasty in 0.3%, 0.6%, and 0% of patients in groups 1, 2, and 3, respectively (p = NS for all comparisons). Vascular complications occurred in 2.8%, 4.9%, and 6.1% in groups 1, 2, and 3, respectively (p <0.05). Six-month follow-up of patients was divided by age: <65 years (n = 564, group 1); 65 to 75 years (n = 221, group 2); and >75 years (n = 122, group 3). Event-free survival was 94.5%, 90.5%, and 89.3% for groups 1, 2, and 3, respectively (p = NS). Death occurred in 0.4%, 0.5%, and 1.6%; myocardial infarction occurred in 1.2%, 2.3%, and 1.6%, and target vessel revascularization in 4.3%, 8.6%, and 7.4% for groups 1, 2, and 3, respectively (p = NS for all comparisons). Thus, coronary stenting produced favorable in-hospital and 6-month outcomes in all 3 age groups. Age itself should not preclude patients from undergoing coronary stenting.