A Novel Mutation of the Calcium-Sensing Receptor Gene Causing Familial Hypocalciuric Hypercalcemia Complicates Medical Followup after Roux-en-Y Gastric Bypass: A Case Report and a Summary of Mutations Found in the Same Hospital Laboratory.

Heterozygous inactivating mutations in the calcium-sensing receptor (CaSR) gene are known to cause familial hypocalciuric hypercalcemia (FHH), usually a benign form of hypercalcemia without symptoms of a disrupted calcium homeostasis. FHH can be mistaken for the more common primary hyperparathyroidism (PHPT), for which surgical treatment may be needed. We describe a case of a 36-year-old woman with hypercalcemia and elevated PTH, initially suspected of having PHPT. Sequencing of the CaSR-gene revealed a mutation in nucleotide 437, changing the amino acid in position 146 from Glycine to Aspartate. The mutation was previously undescribed in the literature, but a very low calcium:creatinine clearance ratio supported the diagnosis FHH. A few years later, the patient's two daughters were tested and the association between mutation and hypercalcemia could be confirmed. The patient was gastric bypass-operated and therefore, due to malabsorption and increased risk of fracture, was in need of adequate calcium supplementation. The chronically elevated calcium levels challenged medical followup, as calcium sufficiency could not be monitored in a traditional manner. Eventually the patient developed elevated alkaline phosphatase, a further increased PTH and a decreased DXA T-score indicating calcium deficiency and bone resorption. As a supplement, all CaSR-mutations found at our hospital, 2005-2018.

Investigation of the association of growth rate in grower-finishing pigs with the quantification of Lawsonia intracellularis and porcine circovirus type 2.

As a part of a prospective cohort study in four herds, a nested case control study was carried out. Five slow growing pigs (cases) and five fast growing pigs (controls) out of 60 pigs were selected for euthanasia and laboratory examination at the end of the study in each herd. A total of 238 pigs, all approximately 12 weeks old, were included in the study during the first week in the grower-finisher barn. In each herd, approximately 60 pigs from four pens were individually ear tagged. The pigs were weighed at the beginning of the study and at the end of the 6-8 weeks observation period. Clinical data, blood and faecal samples were serially collected from the 60 selected piglets every second week in the observation period. In the killed pigs serum was examined for antibodies against Lawsonia intracellularis (LI) and procine circovirus type 2 (PCV2) and in addition PCV2 viral DNA content was quantified. In faeces the quantity of LI cells/g faeces and number of PCV2 copies/g faeces was measured by qPCR. The objective of the study was to examine if growth rate in grower-finishing pig is associated with the detection of LI and PCV2 infection or clinical data. This study has shown that diarrhoea is a significant risk factor for low growth rate and that one log(10) unit increase in LI load increases the odds ratio for a pig to have a low growth rate by 2.0 times. Gross lesions in the small intestine and LI load>log(10)6/g were significant risk factors for low growth. No association between PCV2 virus and low growth was found.

Optimization of high-resolution continuous flow analysis for transient climate signals in ice cores.

Over the past two decades, continuous flow analysis (CFA) systems have been refined and widely used to measure aerosol constituents in polar and alpine ice cores in very high-depth resolution. Here we present a newly designed system consisting of sodium, ammonium, dust particles, and electrolytic meltwater conductivity detection modules. The system is optimized for high-resolution determination of transient signals in thin layers of deep polar ice cores. Based on standard measurements and by comparing sections of early Holocene and glacial ice from Greenland, we find that the new system features a depth resolution in the ice of a few millimeters which is considerably better than other CFA systems. Thus, the new system can resolve ice strata down to 10 mm thickness and has the potential of identifying annual layers in both Greenland and Antarctic ice cores throughout the last glacial cycle.

Frequency of MART-1/MelanA and gp100/PMel17-specific T cells in tumor metastases and cultured tumor-infiltrating lymphocytes.

Melanoma differentiation antigens, such as MART-1/MelanA and gp100/PMel17, frequently are observed as targets of tumor infiltrating lymphocytes (TIL) originated from HLA-A*0201-expressing patients with melanoma. Furthermore, particular clinical relevance was attributed to gp100/pMel17 based on the impression that the adoptive transfer of gp100-recognizing TIL was associated with clinical responses in a small group of patients. However, the actual frequency of specific T cells for these melanoma differentiation antigens has never been directly enumerated in ex vivo or in vitro expanded TIL cultures. Here, we enumerated melanoma differentiation antigen-specific T-cell precursor frequency in TIL using tetrameric HLA/epitope complexes, functionally characterizing their responsiveness to cognate epitope by cytokine release assay. T-cell precursor frequencies were enumerated in 11 fresh-tumor preparations and 17 TIL adoptively transferred into patients bearing HLA-A*0201. MART-1 or gp100-specific T cells could be detected respectively in 5 and 2 of the 11 fresh preparations and in 5 and 2 of the 17 adoptively transferred TIL. With one exception, melanoma differentiation antigen-specific T-cell precursor frequency in fresh material and TIL ranged between 5,000 to 21,000/10(6) CD8+ T cells. T-cell precursor frequency was not significantly higher in TIL whose administration was associated with clinical response. These data provide direct enumeration of MART-1/MelanA and gp100/pMel17 reactivity ex vivo and in vitro in the context of HLA-A*0201.