Genetic analysis of the complete gag and env genes of HIV type 1 subtype C primary isolates from South Africa.

South Africa has one of the fastest growing HIV-1 epidemics, with an estimated 4.7 million people infected. To better understand the genetic diversity of this epidemic and its potential impact on vaccine development, we have cloned and sequenced the complete gag and env genes of 13 primary virus isolates. Phylogenetic analysis of our sequences and 69 complete env genes from the Los Alamos and GenBank databases revealed multiple subclusters within subtype C. The V3 loop region was relatively conserved in all our strains when compared with other subtypes, but the region immediately downstream was highly variable. No intersubtype recombinant forms were observed when comparing the gag and env sequences. Characterization of the complete gag and env genes enabled us to select specific strains for further vaccine development.

Swainsonine: a new antineoplastic immunomodulator.

Swainsonine, an indolizidine alkaloid with immunomodulatory activity, has been found to be effective in inhibiting metastatic dissemination and growth of primary tumors of both murine and human origins. The unique ability of swainsonine to exhibit antimetastatic, anti-proliferative, and immunomodulatory activity imparts this drug a promising future in cancer therapy.

Breast lesions in black women.

A number of studies compared the clinical features and demographic characteristics of black and white patients with diseases of the breast. Only a few, however, dealt with the pathology of breast lesions. In this study, the distribution of breast lesions in blacks and whites (Caucasians) in the accessioned material of the AFIP from 1980 to 1983 was described. Additionally, the distribution of estrogen and progesterone receptors in a total of 425 black patients with breast cancer at Howard University Hospital was studied and the results compared with similar data reported in white American women. In the period January 1, 1980, to January 1, 1983, there were 380 breast lesions from black patients and 3511 comparable lesions from white patients accessioned at the AFIP. A total of 159 black women and 1819 white women were diagnosed with carcinoma of breast. Black patients had 102 (79 percent) invasive duct carcinomas, and white patients had 1112 (78 percent). Black patients with invasive duct carcinoma were generally younger than white patients, as 68 percent of black patients and 53 percent of white patients were younger than 54 years. The difference in age distribution was statistically significant. Lobular carcinoma was less common in blacks than in whites. The relative ratio frequency of mucinous, medullary, and papillary carcinoma was higher in black women than in whites. Tubular carcinoma, however, was more common in whites than in blacks. Black patients had a lower incidence of ER-positive tumors and a higher incidence of ER-negative tumors compared with published data on white patients. Postmenopausal patients were more likely to be ER positive than premenopausal patients. Stratification of the data indicated a lower incidence of ER-positive and a higher incidence of ER-negative breast cancers in both premenopausal and postmenopausal patients compared with published data from institutions with predominantly white patient populations. Microscopic examination revealed a higher frequency of poorly differentiated carcinomas and fewer well- and moderately well-differentiated carcinomas than has been reported for white women with the tumor. There was a significant correlation between tumor grade and receptor positivity. Well-differentiated carcinomas were more likely ER and PR positive than poorly differentiated ones.(ABSTRACT TRUNCATED AT 400 WORDS)

Increased cancer risks in blacks: a look at the factors.

Incidence and mortality rates of cancer in blacks have been increasing at a faster rate than in whites. In particular, recent incidence rates of lung cancer in black men have increased, while the rates in white men decreased for the first time since 1982 to 1983. This leveling off in incidence for whites may suggest the beginning of a downturn in lung cancer because the smoking prevalence has decreased substantially since 1965.There is considerable evidence that cancer risks in blacks are higher than in whites. The major risk factors to cancer include cigarette smoking, diet, alcohol, and occupational exposure to industrial carcinogens. Other factors, including immunogenetic and unknown risks, might be associated partially with an increased incidence of cancer in blacks. Analytic epidemiologic studies addressing the relationship between genetic factors, or biomarkers, and cancer along with epidemiologic methods are warranted. Key factors that contribute to the prevention of cancer mortality should be identified and promulgated through primary or secondary cancer prevention programs.

Skin cancer in black Americans: a review of 126 cases.

Primary cancer of the skin is rare in blacks. The records of 126 black patients with skin cancer were reviewed. Histopathologic findings included squamous cell carcinomas (43) basal cell carcinomas (39) malignant melanomas (8) dermatofibrosarcomas (16) Bowen's disease (6) mycosis fungoides (14) and sebaceous cell carcinoma (1).There is a higher percentage of skin cancer involving covered areas in blacks than among whites. Squamous cell carcinoma was the most common skin cancer in blacks. The distribution of basal cell carcinoma in blacks was 30 percent in this series, as compared with 80 percent in whites in the 1977 to 1978 survey. The majority of patients with squamous cell carcinoma had associated predisposing conditions and lesions on non-sun-exposed skin. Sunlight and occupational chemical exposure did not appear to be associated with skin cancer in blacks in this series.

Neuraminidase production by Candida albicans.

A Candida albicans strain G42, isolated from a vaginal infection, was demonstrated to produce neuraminidase in culture filtrates with activity for N-acyl-neuraminic acid glycoprotein from bovine submaxillary gland, and human erythrocytes as substrates. Incubation of viable cells from G42 with human group O Rh(+) erythrocytes released N-acetyl-neuraminic acid in a time-dependent manner. Thirty-two clinical isolates of C albicans were studied for neuraminidase production. Enzyme activity was found in culture filtrates from five strains.It would appear important from these data to determine whether the production of neuraminidase by C albicans can be correlated with pathogenicity.

Ultrastructure of the gonads in the testicular feminization syndrome.

The testicular feminization syndrome is a form of familial male pseudohermaphroditism transmitted by an X-linked gene. The karyotype is 46XY. Affected patients resemble normal females phenotypically. To date, only eight cases of this syndrome have been studied by electron microscope. This study reports the ultrastructural appearance of the gonads in two additional patients. The presence of mature interstitial cells with a rich endoplasmic reticulum suggests that the pathologic defect is not due to a lack of androgenic hormone production by the testes but is caused by peripheral end-organ resistance.

Breast ductal carcinoma with osseous metaplasia.

The case of an elderly patient with one of the rarest forms of breast carcinoma is reported. Histomorphologic aspects and theories as to its origin are discussed.

Estrogen and progesterone receptors in breast cancer in Black Americans: Correlation of receptor data with tumor differentiation.

It has been observed that 60-70% of breast cancer patients have estrogen receptors (ER) and that nearly two-thirds of such patients respond favorably to endocrine therapy. Cytosolic ER and progesterone receptors (PgR) have been evaluated in the current study, among 146 black women with breast cancer in order to determine whether the distribution of ER and PgR differs from the national norm. The results showed following trends that were similar to reports from other institutions: (1) postmenopausal patients and primary tumors showed higher ER positivity than premenopausal patients and metastatic sites, respectively; (2) a significant correlation between the ER positivity and tumor grade; and (3) a higher PgR positivity in ER-positive patients than in ER-negative patients. However, statistically significant differences were observed in three parameters when compared to reports from other institutions on white patients: (1) a low incidence of ER-positive (46%) and high incidence of ER-negative (42%) tumors; (2) a higher incidence of poorly differentiated (55.5%) and a lower incidence of well differentiated (5.5%) tumors; tumor grade was independent of age, menopausal status, histopathology and stage; and (3) a higher percentage of patients discovered at a more advanced stage of the disease. The clinical implications of these results in explaining the relatively poorer survival of black women with breast cancer compared to whites is discussed. Whether this high incidence of PD tumors and thus a high incidence of ER negativity is due to ethnic differences and/or environmental and other factors remains to be elucidated.

A rapid passive hemagglutination method for demonstrating serum antibodies to Candida albicans.

Soluble components from disrupted cells of Candida albicans, a yeast-like fungus which is a normal commensal in the throat and nasopharynx were conjugated by bis-diazotized benzidine to turkey erythrocytes to produce sensitized particles capable of reacting with specific serum anti-Candida factors. The rapid sedimentation of conjugated nucleated turkey cells in the presence of antibody permits hemagglutination titers to be read in less than an hour. Preliminary results indicate that this test which offers speed, specificity, and reproducibility may be of importance in monitoring changes in levels of anti-Candida factors in human sera.

Simultaneous primary carcinomas--a report of three cases.

Two separate primary carcinomas occurring simultaneously in the esophagus and stomach are uncommon. The authors report three cases of this entity, squamous cell carcinoma of the osophagus and adenocarcinoma of the stomach, one of which is classified as a collision carcinoma of the stomach. Because of the rarity of collision tumors of this histologic variety, the world literature was reviewed. Diagnostic features and the relative prognosis of dual primary carcinomas are discussed.

The lung in sickle cell disease: a clinical overview of common vascular, infectious, and other problems.

Acute pulmonary complications of sickle cell anemia are sickle cell lung disease and bacterial pneumonias. Chronic abnormalities in lung function include a restrictive ventilatory defect and perhaps increased venous admixture to the pulmonary circulation. Coexisting sarcoidosis may complicate sickle cell anemia and interact to potentiate sickling. Sickle cell lung disease, or acute "chest syndrome," occurs with greatest frequency in adults, is due primarily to pulmonary infarction, and may lead to cor pulmonale. On the other hand, bacterial pneumonia due to Streptococcus pneumoniae occurs with greater frequency in infancy and childhood. Mycoplasma and other organisms may also cause pneumonia with protracted illness and slow resolution. Bacteremia and meningitis may be further complications, particularly in children. Precise diagnosis of the acute febrile pulmonary episode is often difficult. In adults the illness is commonly self-limited. However, a vigorous diagnostic approach is warranted in all severely ill patients.

Serratia: a continuing health menace.

Species of Serratia, particularly S marcescens, are being isolated with increasing frequency from human sources. These organisms are responsible for serious infections, especially in hospitalized and/or compromised patients. The authors reviewed the frequency of isolation of Serratia species at Howard University Hospital and analyzed isolation and identification techniques and factors predisposing patients to colonization by these organisms. This paper presents the findings of the study.

Tricuspid valve and papillary muscle avulsion following flow-directed catheter removal.

A case is presented of tricuspid valve and papillary muscle avulsion which occurred during removal of a Swan-Ganz catheter. A review of pertinent literature and discussion of a possible mechanism for the cause of the complication and its prevention are presented.The authors believe this to be the first reported instance of such a complication.

Sarcoidosis: a comparative study of diagnostic procedures.

The diagnosis of sarcoidosis, as with other intrathoracic lesions, remains a challenge to the clinician. An adequate history, a thorough physical examination, and the employment of various laboratory tests often establish the diagnosis. When a definitive diagnosis is not made, biopsy of suspected lesions is indicated. Various diagnostic procedures are presented and compared.

Shigellosis: analysis of 176 isolations.

Shigellosis, a worldwide epidemiological problem, is caused usually by six serotypes of Shigella. Man is the principal host, often infected by person-to-person contact. The number of reported cases of shigellosis has progressively increased during the past decade. Because of the observation, the authors reviewed all isolations of Shigella species in patients at Howard University Hospital. There were 176 isolations from 53 patients during the 4½ year period of the study. The study emphasizes the scope and distribution of the disease and the effectiveness of isolation and identification procedures.