Using personal monitoring data to derive organ doses for medical radiation workers in the Million Person Study-considerations regarding NCRP Commentary no. 30.

The study of low dose and low-dose rate exposure is of central importance in understanding the possible range of health effects from prolonged exposures to radiation. The One Million Person Study of Radiation Workers and Veterans (MPS) of low-dose health effects was designed to evaluate radiation risks among healthy American workers and veterans. The MPS is evaluating low-dose and dose-rate effects, intakes of radioactive elements, cancer and non-cancer outcomes, as well as differences in risks between women and men. Medical radiation workers make up a large group of individuals occupationally exposed to low doses of radiation from external x-ray/gamma exposures. For the MPS, about 100 000 United States medical radiation workers have been selected for study. The approach to the complex dosimetry circumstances for such workers over three to four decades of occupation were initially and broadly described in National Council on Radiation Protection and Measurements (NCRP) Report No. 178. NCRP Commentary No. 30 provides more detail and describes an optimum approach for using personal monitoring data to estimate lung and other organ doses applicable to the cohort and provides specific precautions/considerations applicable to the dosimetry of medical radiation worker organ doses for use in epidemiologic studies. The use of protective aprons creates dosimetric complexity. It is recommended that dose values from dosimeters worn over a protective apron be reduced by a factor of 20 for estimating mean organ doses to tissues located in the torso and that 15% of the marrow should be assumed to remain unshielded for exposure scenarios when aprons are worn. Conversion coefficients relating personal dose equivalent,Hp(10) in mSv, to mean absorbed doses to organs and tissues,DTin mGy, for females and males for six exposure scenarios have been determined and presented for use in the MPS. This Memorandum summarises several key points in NCRP Commentary No. 30.

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

Abstract: In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

Estimates of genetic parameters associated with lactation feed intake and growth and composition traits measured during a performance test.

Days to reach 113.4 kg, adjusted backfat depth and adjusted loin muscle area to 113.4 kg were evaluated on pure-bred Landrace (n = 15 660) and Yorkshire (n = 14 808) boars and gilts. Daily lactation feed intake (LFI) was recorded within parity records from pure-bred Yorkshire (n = 1587) and Landrace (n = 2197) females during day 1-22 of lactation, and LFI curves were predicted using a mixed model. Evaluation of feed intake differences between 2 consecutive days of lactation resulted in the following periods: day 1-6 (PB1), day 7-10 (PB2) and day 11-18 (PB3). Average rate of change in intake (ARC), average daily intake (ADI) and variation from predicted daily LFI values (VAR) metrics were computed for each period of lactation. Gibbs sampling was used to estimate the genetic covariance between LFI metrics and grow-finish traits. Genetic correlations were strongest between grow-finish traits, and LFI metrics in first parity sows and were generally favourable, but correlations with LFI metrics during parity 2 or greater were low and not different from 0 (p > 0.05). Genetic correlations between LFI metrics in parity 1 sows with growth and composition traits varied greatly in strength and direction. Selection for leaner, heavier muscled gilts had a limited effect on LFI metrics. However, selection for increased growth rate was associated with higher ARC and ADI and smaller VAR values.

Estimates of genetic parameters associated with lactation feed intake and reproductive performance in purebred and F1 sows.

Daily feed intake during lactation was recorded in parity records from purebred Yorkshire (n = 1587), Landrace (n = 2197) and reciprocal cross F1 (n = 6932) females, and lactation feed intake (LFI) curves were predicted using a mixed model. Evaluation of the difference in feed intake between two consecutive days of lactation resulted in the following classifications: three periods for purebreds, days 1-6, days 7-10 and days 11-18, and two periods for F1 sows, days 1-5 and days 6-18. Average rate of change in intake (ARC), average daily intake (ADI) and variation from predicted LFI values (VAR) were computed for each period of lactation. Gibbs sampling was used to estimate genetic (co)variance components for LFI metrics and reproductive performance traits. Genetic variance estimates for each LFI metric were obtained with univariate animal models, and covariance estimates were estimated with bivariate models. Heritability estimates for ADI, ARC and VAR metrics computed over the duration of lactation were 0.37, 0.24, and 0.16, respectively. Heritability estimates were highly variable across periods of lactation for ARC (0.03-0.17), ADI (0.09-0.36) and VAR (0.04-0.18) metrics in purebred and F1 populations. Genetic correlations between LFI metrics and reproductive traits were relatively low, although LFI metrics later in lactation were more highly correlated with reproductive performance.

Effect of method of delivering nicarbazin to mallards on plasma 4,4'-dinitrocarbanilide levels and reproduction.

Nicarbazin (NCZ), a coccidiostat used in the poultry industry, has been developed as a contraceptive for resident Canada geese. We tested the efficacy of NCZ as a contraceptive using mallards (Anas platyrhynchos) as a model for Canada geese. Nicarbazin-treated corn was fed ad libitum for 14 d at 0, 750, 1,000, or 1,500 ppm. Plasma and egg levels of 4,4'-dinitrocarbanilide (DNC), the active anticoccidial component of NCZ, differed among treatment groups in a dose-response relationship, but plasma levels did not differ between sexes. Nicarbazin caused a decrease in egg weight, but there was no effect of NCZ on the numbers of eggs laid per female per day. Nicarbazin did not significantly impact bird health. An additional trial tested the effect of the method of NCZ delivery on plasma DNC levels. Mallards were given NCZ daily for 12 d either by gavage with a corn oil suspension, gavage with a water suspension, peroral administration of a capsule, or feeding 500 mg of NCZ/kg of pelleted feed ad libitum. The method of delivery significantly affected plasma DNC levels, with the highest levels in the corn oil suspension group and the lowest levels in the pelleted feed group. This is likely due to decreased availability of NCZ in a pellet compared with gavage with a suspension or capsule. Mallards receiving 34.2 mg of NCZ/kg of BW when fed cracked corn coated with NCZ daily for 14 d had higher plasma DNC levels than those obtained by liquid gavage, capsule, or pelleted NCZ feed. For maximum effect in the field, NCZ should be coated onto corn. A higher concentration of NCZ is needed in pelleted feed to obtain comparable plasma DNC levels to allow for the decreased absorption of DNC.

Molecular effects of nicarbazin on avian reproduction.

Nicarbazin (NCZ) is an anticoccidial drug routinely used in the poultry industry that can negatively affect reproduction by reducing egg production, egg weight, and egg hatchability. The molecular mechanisms by which NCZ affects reproduction are unknown. Lipoprotein lipase, vitellogenin, transglutaminase, and calcium are all involved in egg formation and embryogenesis. Therefore, in vitro assays were used to evaluate 4 potential mechanisms of action of NCZ on egg formation and embryogenesis. First, a lipoprotein lipase assay was conducted to determine if NCZ increases lipoprotein lipase activity. Second, vitellogenin phosphorylation was evaluated to determine if NCZ acts as a vitellogenin phosphatase. Third, transglutaminase activity was measured to determine if NCZ inhibits transglutaminase activity. Finally, bull sperm was used as a model to determine if specific channel-mediated calcium uptake can be blocked by NCZ. Nicarbazin increased the activity of lipoprotein lipase in vitro at 3.9 and 7.8 microg of NCZ/mL. Nicarbazin increased intracellular calcium levels in bull sperm, suggesting it also acts as a calcium ionophore. The portion of the NCZ molecule responsible for the increase in intracellular calcium is 2-hydroxy-4,6-dimethylpyrimidine. Nicarbazin affected vitellogenin phosphorylation but only at a concentration many times higher than expected plasma values. Nicarbazin also inhibited transglutaminase activity in vitro. Whereas the 4,4'-dinitrocarbanilide portion of the NCZ molecule inhibited transglutaminase activity, the 2-hydroxy-4,6-dimethylpyrimidine portion increased transglutaminase activity. All of these assays were conducted in vitro; therefore these results should be viewed as preliminary findings to aid in directing further research on the effect of NCZ on reproduction in vivo. Because NCZ increases lipoprotein lipase activity and acts as a calcium ionophore, future experiments should investigate these effects in particular.

Evaluation of nicarbazin as a potential waterfowl contraceptive using mallards as a model.

Contraception may provide a useful nonlethal management tool to reduce wild bird populations. We tested the efficacy of nicarbazin (NCZ) as a contraceptive for waterfowl and assessed health effects of NCZ, using domestic mallards (Anas platyrhynchos) as a model for Canada geese (Branta canadensis). Mallards were given gelatin capsules containing 0, 8.5, 17.0, or 33.75 mg of NCZ/kg of BW perorally once daily for 14 d. Fecal 4,4'-dinitrocarbanilide (DNC) and fluorescein were evaluated as potential markers of plasma and egg DNC levels. Plasma, egg, and fecal DNC levels differed among treatment groups in a dose response relationship. There were no significant effects on the numbers of eggs laid per female per day, proportion of fertile eggs, proportion of eggs hatching, or egg yolk mottling. Hatchability was 0.55 +/- 0.1 in the control group compared with 0.26 +/- 0.1 in the 33.75 mg/kg of BW group. Degeneration of the vitelline membrane was evident at all treatment levels; severity was dose-related and greater in the outer vitelline membrane than the inner vitelline membrane. No significant health effects were observed for birds treated with NCZ. The heterophil:lymphocyte ratio was elevated during the treatment and posttreatment periods in all groups, indicating birds were experiencing stress due to handling. Fecal DNC levels did not correlate well with plasma DNC levels, likely due to NCZ being administered as a bolus dose rather than being fed ad libitum. Fluorescein correlated well with plasma DNC levels during the treatment period and can therefore be used successfully as a noninvasive marker to determine the approximate amount of NCZ a bird is consuming. As a contraceptive, NCZ likely would have minimal adverse health effects on the target animal, although field studies with the species of interest need to be conducted. Further research using higher NCZ levels needs to be conducted to determine whether NCZ can inhibit reproduction in waterfowl.

Comparison of nicarbazin absorption in chickens, mallards, and Canada geese.

Nicarbazin (NCZ), a coccidiostat commonly used in the poultry industry, causes reduced hatchability and egg quality in layer hens at a concentration of 125 ppm (8.4 mg/kg) in the feed. Although this effect is undesirable in the poultry industry, NCZ could provide a useful wildlife contraception tool for waterfowl, particularly urban geese. We tested the absorption of NCZ in chickens (Gallus gallus), mallards (Anas platyrhynchos), and Canada geese (Branta canadensis) gavaged with 8.4 mg of NCZ/kg per bird each day for 8 d. Plasma levels of 4,4'-dinitrocarbanilide (DNC) differed significantly among species. Peak plasma DNC levels were 2.87 +/- 0.15 microg/mL, 2.39 +/- 0.15 microg/mL, and 1.53 +/- 0.15 microg/ mL in chickens, mallards, and Canada geese respectively. It took 6 d to obtain peak DNC levels in chickens as opposed to 8 d in mallards and Canada geese. The half life of DNC in plasma was 1.43 d in chickens, 0.72 d in mallards, and 1.26 d in Canada geese. Mallards eliminated 100% of plasma DNC 4 d post-treatment, whereas Canada geese eliminated 100% of plasma DNC 8 d post-treatment. Chickens had only eliminated 99% of plasma DNC 8 d post-treatment. Mallard plasma DNC levels were highly correlated with Canada goose plasma DNC levels. This research showed mallards are an ideal model species for the Canada goose for future reproductive studies on NCZ in a laboratory setting. However, levels higher than 8.4 mg/kg must be fed to waterfowl in order to obtain a plasma level comparable to chickens.

Effectiveness of twenty, twenty-five diazacholesterol, avian gonadotropin-releasing hormone, and chicken riboflavin carrier protein for inhibiting reproduction in Coturnix quail.

Contraception may provide a useful nonlethal management tool when it is desirable to reduce populations of birds. We tested the efficacy of 20,25 diazacholesterol, and immunization with avian gonadotropin-releasing hormone (AGnRH-I) and chicken riboflavin carrier protein (cRCP) as contraceptives and investigated their modes of action in Coturnix quail (Coturnix coturnix japonica). Females that were paired with males treated with 20,25 diazacholesterol produced lower percentages of eggs that were fertile and hatched. Females treated with 20,25 diazacholesterol and paired with control males laid fewer eggs, and lower percentages of their eggs were fertile and hatched. Treatment with 20,25 diazacholesterol reduced testosterone levels in males and progesterone levels in females. Nonesterified cholesterol levels were reduced, whereas desmosterol levels increased in birds treated with 20,25 diazacholesterol. Treatment with AGnRH-I and cRCP immunocontraceptive vaccines did not decrease average egg production and hatchability or hormone levels, but this failure might have been due to the vaccination protocol. If registered, wildlife managers may be able to use 20,25 diazacholesterol when other methods, such as lethal control, are undesirable for reducing damage caused by specific breeding behaviors such as the building of nests.

Fluid core size of Mars from detection of the solar tide.

The solar tidal deformation of Mars, measured by its k2 potential Love number, has been obtained from an analysis of Mars Global Surveyor radio tracking. The observed k2 of 0.153 +/- 0.017 is large enough to rule out a solid iron core and so indicates that at least the outer part of the core is liquid. The inferred core radius is between 1520 and 1840 kilometers and is independent of many interior properties, although partial melt of the mantle is one factor that could reduce core size. Ice-cap mass changes can be deduced from the seasonal variations in air pressure and the odd gravity harmonic J3, given knowledge of cap mass distribution with latitude. The south cap seasonal mass change is about 30 to 40% larger than that of the north cap.

Emotional closeness with perpetrators and amnesia for child sexual abuse.

Over the past decade, a contentious debate regarding delayed memories of childhood sexual abuse (CSA) has existed. In order to address this debate, 240 female participants completed questions about CSA, the Dissociative Experience Scale (Bernstein & Putnam, 1986), Perceived Emotional Closeness with Perpetrator Scale (Schultz, Passmore, & Yoder, 2000), and the Gudjonsson Suggestibility Scale 2 (GSS 2) (Gudjonsson, 1987). Eighty-two (36%) reported CSA and 37% of these indicated memory disturbances for the CSA. Participants reporting memory disturbances also reported significantly higher numbers of perpetrators, chemical abuse in their families, and closer relationships with the perpetrator(s) than participants reporting no memory disturbances. Implications for clinicians working with clients reporting CSA are discussed.

Hydraulic redistribution in a stand of Artemisia tridentata: evaluation of benefits to transpiration assessed with a simulation model.

The significance of soil water redistribution facilitated by roots (an extension of "hydraulic lift", here termed hydraulic redistribution) was assessed for a stand of Artemisia tridentata using measurements and a simulation model. The model incorporated water movement within the soil via unsaturated flow and hydraulic redistribution and soil water loss from transpiration. The model used Buckingham-Darcy's law for unsaturated flow while hydraulic redistribution was developed as a function of the distribution of active roots, root conductance for water, and relative soil-root (rhizosphere) conductance for water. Simulations were conducted to compare model predictions with time courses of soil water potential at several depths, and to evaluate the importance of root distribution, soil hydraulic conductance and root xylem conductance on transpiration rates and the dynamics of soil water. The model was able to effectively predict soil water potential during a summer drying cycle, and the rapid redistribution of water down to 1.5 m into the soil column after rainfall events. Results of simulations indicated that hydraulic redistribution could increase whole canopy transpiration over a 100-day drying cycle. While the increase was only 3.5% over the entire 100-day period, hydraulic redistribution increased transpiration up to 20.5% for some days. The presence of high soil water content within the lower rooting zone appears to be necessary for sizeable increases in transpiration due to hydraulic redistribution. Simulation results also indicated that root distributions with roots concentrated in shallow soil layers experienced the greatest increase in transpiration due to hydraulic redistribution. This redistribution had much less effect on transpiration with more uniform root distributions, higher soil hydraulic conductivity and lower root conductivity. Simulation results indicated that redistribution of water by roots can be an important component in soil water dynamics, and the model presented here provides a useful approach to incorporating hydraulic redistribution into larger models of soil processes.

Correlation between reduction in plasma HIV-1 RNA concentration 1 week after start of antiretroviral treatment and longer-term efficacy.

BACKGROUND: Early assessment of antiretroviral drug efficacy is important for prevention of the emergence of drug-resistant virus and unnecessary exposure to ineffective drug regimens. Current US guidelines for changing therapy are based on measurements of plasma HIV-1 RNA concentrations 4 or 8 weeks after the start of treatment with cut-off points of 0.75 or 1.00 log, respectively. We investigated the possibility of assessing drug efficacy from measurements of plasma HIV-1 concentrations made during the first week on therapy. METHODS: The kinetics of virus decay in plasma during the first 12 weeks of treatment was analysed for 124 HIV-1-infected patients being treated for the first time with a protease inhibitor. Patients with a continuous decline of HIV-1 concentrations and in whom HIV-1 was either undetectable or declined by more than 1.5 log at 12 weeks were defined as good responders; the rest were poor responders. FINDINGS: The individual virus decay rate constants (k) at day 6 correlated significantly (r>0.66, p<0.0001) with changes in HIV-1 concentrations at 4, 8, and 12 weeks, and correctly predicted 84% of the responses with a cut-off value of k=0.21 per day (in log scale). Reduction in plasma HIV-1 of less than 0.72 log by day 6 after initiation of therapy predicted poor long-term responses in more than 99% of patients. INTERPRETATION: These results suggest that changes in HIV-1 concentration at day 6 after treatment initiation are major correlates of longer-term virological responses. They offer a very early measure of individual long-term responses, suggesting that treatment could be optimised after only a few days of therapy.

Short-cycle structured intermittent treatment of chronic HIV infection with highly active antiretroviral therapy: effects on virologic, immunologic, and toxicity parameters.

Although continuous highly active antiretroviral therapy (HAART) is effective for many HIV-infected patients, it can be toxic and prohibitive in cost. By decreasing the total amount of time patients receive medications, intermittent HAART could reduce toxicity and cost. Therefore, we initiated a pilot study in which 10 HIV-infected individuals receiving effective therapy that resulted in levels of HIV RNA <50 copies per ml of plasma and CD4(+) T cell counts >300 cells per mm(3) of whole blood received repeated cycles of 7 days on HAART followed by 7 days off of HAART. Patients maintained suppression of plasma viremia for 32-68 weeks. There was no significant increase in HIV proviral DNA or replication-competent HIV in peripheral CD4(+) T cells or HIV RNA in peripheral blood or lymph node mononuclear cells. There was no significant change in CD4(+) T cell counts, no significant increase in CD4(+) or CD8(+) T cells expressing activation markers or producing IFN-gamma in response to HIV, no increase in CD4(+) T cell proliferation to p24 antigen, and no evidence for the development of resistance to HAART medications. There was a significant decrease in serum cholesterol and triglyceride levels. Thus, in this proof-of-concept study, short-cycle intermittent HAART maintained suppression of plasma viremia as well as HIV replication in reservoir sites while preserving CD4(+) T cell counts. In addition, there was a decrease in serum cholesterol and triglyceride levels. Intermittent therapy may be an important strategy to reduce cost and toxicity for HIV-infected individuals.

Evidence for increased T cell turnover and decreased thymic output in HIV infection.

The effects of HIV infection upon the thymus and peripheral T cell turnover have been implicated in the pathogenesis of AIDS. In this study, we investigated whether decreased thymic output, increased T cell proliferation, or both can occur in HIV infection. We measured peripheral blood levels of TCR rearrangement excision circles (TREC) and parameters of cell proliferation, including Ki67 expression and ex vivo bromodeoxyuridine incorporation in 22 individuals with early untreated HIV disease and in 15 HIV-infected individuals undergoing temporary interruption of therapy. We found an inverse association between increased T cell proliferation with rapid viral recrudescence and a decrease in TREC levels. However, during early HIV infection, we found that CD45RO-CD27high (naive) CD4+ T cell proliferation did not increase, despite a loss of TREC within naive CD4+ T cells. A possible explanation for this is that decreased thymic output occurs in HIV-infected humans. This suggests that the loss of TREC during HIV infection can arise from a combination of increased T cell proliferation and decreased thymic output, and that both mechanisms can contribute to the perturbations in T cell homeostasis that underlie the pathogenesis of AIDS.

Determination of 4,4'-dinitrocarbanilide (DNC), the active component of the antifertility agent nicarbazin, in chicken, duck, and goose plasma.

4,4'-Dinitrocarbanilide (DNC) was extracted from chicken, duck, and goose plasma and isolated by reversed-phase high-performance liquid chromatography. DNC was detected by ultraviolet absorbance at 347 nm and quantified by comparison to a calibration standard. Recovery data were determined by analyzing DNC-fortified control plasma. The mean recovery of DNC in fortified chicken plasma samples was 99.7 +/- 1.9% for 0.18 and 9.1 ppm DNC, and in fortified duck and goose plasma samples was 99.5 +/- 4.9% and 101.4 +/- 4.5%, respectively, for 0.18, 9.1, and 18 ppm DNC.

Cognitive functioning in the last year of life as a function of age, gender, and race.

Research has shown that many factors affect cognitive functioning. In this study cognitive functioning was analyzed using proxy reports concerning 17,135 decedents included in the 1993 National Followback Mortality Study conducted for the National Center for Health Statistics. These responses form a representative sample of all U.S. residents over age 15 who died in 1993 (except for those in South Dakota, which did not participate). Decedents had more difficulty understanding where they were than remembering what year it was or in recognizing family members. Logistic regression models found that age, gender, and race were the most important predictors of these basic cognitive functions. Although increasing age was associated with more cognitive difficulties, men had fewer deficits than women and Black Americans tended to have fewer deficits than White Americans. Possible reasons for these findings are discussed as well as some general implications for health service provision.

Determination of DiazaCon in quail feed and quail serum by ion pair reversed-phase chromatography.

Liquid chromatographic (LC) methods were developed for quantitating the potential avian contraceptive DiazaCon in quail feed and serum. DiazaCon was extracted from ground quail feed with basic n-butyl chloride. The n-butyl chloride extract was evaporated to dryness. The DiazaCon residues were dissolved in an aqueous methanolic ion pairing solution and quantitated by LC at 206 nm. Avian sera was combined with an equal volume of a pH 4 aqueous solution of ion pairing reagent and filtered to remove interfering proteins. DiazaCon was quantitated by LC. Mean recoveries for 500 and 2000 ppm fortified feed were 89.1 and 91.0%, respectively. The mean recovery for sera fortified at 5 levels ranging from 35 to 2000 ppm was 84.9%. Method limits of detection were approximately 14 and 13 ppm for feed and sera, respectively.

Examination of variation in sternal rib end morphology relevant to age assessment.

The morphology of the sternal end of the right fourth rib has been proffered as an accurate age assessor in skeletonized individuals of both sexes. This technique was tested for its applicability on left and right II, III, V-IX. Tests were performed between phase scores obtained from right and left ribs; right rib IV phase scores and scores obtained from the others in the right rib series; and between right rib IV scores and a composite score composed of the average of an individual's phase scores (omitting rib IV). Left ribs IV-IX were found not to vary significantly from their right counterparts. Although only right rib II was found to vary significantly from rib IV, use of the other ribs in the series should be undertaken with caution due to questions concerning their statistical significance. A composite score is therefore recommended for use instead.

Rapid activation of lymph nodes and mononuclear cell HIV expression upon interrupting highly active antiretroviral therapy in patients after prolonged viral suppression.

OBJECTIVE: To compare the architecture and HIV-1 RNA and Gag p24 protein expression in lymph nodes (LN) excised from individuals during chronic highly active antiretroviral therapy (HAART) with LN removed from the same patient after plasma virus rebound following the interruption of HAART. MATERIALS AND METHODS: Six HIV-1-infected patients on HAART, with CD4 cell counts greater than 350 cells/microl, and plasma HIV-1 RNA less than 50 copies/ml, underwent inguinal LN excision upon discontinuation of HAART, and again after rebound of plasma virus. Lymph nodes were evaluated by immunohistochemical staining for Gag p24 antigen and Ki67, in-situ hybridization for HIV-1 RNA and H3-histone, and transmission electron microscopy (TEM). RESULTS: LN at baseline were quiescent to mildly hyperplastic and generally contained more primary than secondary follicles. Only one LN had detectable follicular dendritic cell (FDC)-associated p24 antigen, none had HIV RNA. Few mononuclear cells (MNC) expressed RNA or p24 antigen. Plasma virus at the second biopsy ranged from 329 to 3.2 x 10(6) copies/ml. CD4 cell count decline ranged from 5 to 51% during drug hiatus, and was greatest in patients with highest viral rebound. Four of six of the second LN were more hyperplastic than the initial LN, two showed paracortical hyperplasia. MNC expression of HIV RNA in the second LN paralleled the level of plasma viremia. Increased Ki67 and H3-histone signal occurred in the second LN. CONCLUSION: Quiescent LN from individuals on HAART rapidly become hyperplastic and activated within 1-2 months after treatment interruption. As in acute HIV infection, virus expression by LN MNC parallels the rebound in plasma viremia and fall in CD4 cell count.