Advances in the development of Salmonella-based vaccine strategies for protection against Salmonellosis in humans.

Salmonella spp. are important human pathogens globally causing millions of cases of typhoid fever and non-typhoidal salmonellosis annually. There are only a few vaccines licensed for use in humans which all target Salmonella enterica serovar Typhi. Vaccine development is hampered by antigenic diversity between the thousands of serovars capable of causing infection in humans. However, a number of attenuated candidate vaccine strains are currently being developed. As facultative intracellular pathogens with multiple systems for transporting effector proteins to host cells, attenuated Salmonella strains can also serve as ideal tools for the delivery of foreign antigens to create multivalent live carrier vaccines for simultaneous immunization against several unrelated pathogens. Further, the ease with which Salmonella can be genetically modified and the extensive knowledge of the virulence mechanisms of this pathogen means that this bacterium has often served as a model organism to test new approaches. In this review we focus on (1) recent advances in live attenuated Salmonella vaccine development, (2) improvements in expression of foreign antigens in carrier vaccines and (3) adaptation of attenuated strains as sources of purified antigens and vesicles that can be used for subunit and conjugate vaccines or together with attenuated vaccine strains in heterologous prime-boosting immunization strategies. These advances have led to the development of new vaccines against Salmonella which have or will soon be tested in clinical trials.

The Development of Integration in Marsupial and Placental Limbs.

The morphological interdependence of traits, or their integration, is commonly thought to influence their evolution. As such, study of morphological integration and the factors responsible for its generation form an important branch of the field of morphological evolution. However, most research to date on post-cranial morphological integration has focused on adult patterns of integration. This study investigates patterns of correlation (i.e., morphological integration) among skeletal elements of the fore- and hind limbs of developing marsupial and placental mammals. The goals of this study are to establish how patterns of limb integration vary over development in marsupials and placentals, and identify factors that are likely responsible for their generation. Our results indicate that although the overall pattern of correlation among limb elements is consistent with adult integration throughout mammalian development, correlations vary at the level of the individual element and stage. As a result, the relative integration among fore- and hind limb elements varies dynamically between stages during development in both marsupial and placental mammals. Therefore, adult integration studies of the limbs may not be indicative of developmental integration. Results are also consistent with integration during early limb development being more heavily influenced by genetic and developmental factors, and later by function. Additionally, results are generally consistent with a constraint on marsupial forelimb evolution caused by the functional requirements of the crawl to the teat that operates by limiting morphological variation before and at the time of birth, and not after.

Failure of intravitreal bevacizumab in the treatment of choroidal metastasis.

BACKGROUND: Metastasis to choroid is the most common intraocular malignancy, arising most frequently from carcinoma of breast in women and lung in men. Recent case reports have described successful use of intravitreal bevacizumab to achieve local control of such tumours. MATERIALS AND METHODS: Five cases of choroidal metastases from varying primaries: breast, lung, and colon were treated with intravitreal bevacizumab, and tumour response observed and documented with serial photographs and B-scans. RESULTS: Four of the five tumours were seen to progress despite intravitreal bevacizumab treatment. CONCLUSIONS: Intravitreal bevacizumab as the primary treatment of choroidal metastases is not recommended and should not delay more effective alternative treatments.

Defending the fort: a role for defensin-2 in limiting Rickettsia montanensis infection of Dermacentor variabilis.

The importance of tick defensins is evidenced by their expression in a wide variety of tick tissues and prevalence across many tick genera. To date, the functional and biological significance of defensin-2 as a rickettsiastatic or rickettsiacidal antimicrobial peptide has not been addressed. In a previous study, defensin-2 transcription was shown to increase in Dermacentor variabilis ticks challenged with Rickettsia montanensis. In the present study, the hypothesis that defensin-2 is functional as a rickettsiastatic and/or rickettsiacidal antimicrobial peptide is tested. We show that defensin-2 plays a role in reducing burden after acquisition of Rickettsia montanensis through capillary feeding. Moreover, defensin-2 is shown to associate with R. montanensis in vitro and in vivo, causing cytoplasmic leakiness.

Integration of the mammalian shoulder girdle within populations and over evolutionary time.

Morphological integration has the potential to link morphological variation within populations with morphological evolution among species. This study begins to investigate this link by comparing integration among shoulder girdle elements (e.g. scapular blade, glenoid, coracoid, etc.) during the origin and evolution of therian mammals, and within modern bat, opossum and mouse populations. In this study, correlations among skeletal elements and patterns of allometry are used as proxies for integration. Results suggest that shoulder girdle elements tended to vary and evolve independently during the origin of mammals and subsequent radiation of placentals, consistent with the elements' distinct developmental and evolutionary origins. This finding suggests that skeletal element correlations, and therefore integration, can be conserved over large taxonomic and temporal scales. However, marsupials display a different pattern in which shoulder girdle elements tend to be more integrated, with the exception of the coracoid. This finding is consistent with a shift in the pattern of skeletal element integration coincident with the appearance of the marsupial mode of reproduction. This finding provides further evidence that development can play a significant role in the establishment of patterns of skeletal element correlation and that patterns of skeletal element correlation can themselves evolve when faced with sufficient selective pressures.

Molecular determinants of bat wing development.

The specialization of the forelimb into a wing allowed bats to become the only mammals to achieve powered flight. Recent studies in developmental biology have begun to elucidate the molecular mechanisms behind elements of this important morphological transformation. Specifically, researchers have identified molecular changes contributing to: the formation of the bat wing membrane, the elongation of skeletal elements of the bat wing and the reduction of the bat ulna. The general picture emerging from this research is that small changes in the expression of genes critical to many aspects of development have driven large changes in bat wing morphology. Thus, bats can be added to the growing list of groups in which expression changes in key developmental genes have been linked to the evolution of morphological innovations (e.g. early bilaterians, cetaceans, insects).

The correlated evolution of Runx2 tandem repeats, transcriptional activity, and facial length in carnivora.

To assess the ability of protein-coding mutations to contribute to subtle, inter-specific morphologic evolution, here, we test the hypothesis that mutations within the protein-coding region of runt-related transcription factor 2 (Runx2) have played a role in facial evolution in 30 species from a naturally evolving group, the mammalian order Carnivora. Consistent with this hypothesis, we find significant correlations between changes in Runx2 glutamine-alanine tandem-repeat ratio, and both Runx2 transcriptional activity and carnivoran facial length. Furthermore, we identify a potential evolutionary mechanism for the correlation between Runx2 tandem repeat ratio and facial length. Specifically, our results are consistent with the Runx2 tandem repeat system providing a flexible genetic mechanism to rapidly change the timing of ossification. These heterochronic changes, in turn, potentially act on existing allometric variation in carnivoran facial length to generate the disparity in adult facial lengths observed among carnivoran species. Our results suggest that despite potentially great pleiotropic effects, changes to the protein-coding regions of genes such as Runx2 do occur and have the potential to affect subtle morphologic evolution across a diverse array of species in naturally evolving lineages.

Feasibility of using ultrasonic irradiation to recover active biomass from waste activated sludge.

Under typical operating conditions, the microbial fraction of activated sludge flocs is approximately 40% by weight. The objective of this research is to evaluate the feasibility of using ultrasonic irradiation to disrupt activated sludge flocs allowing for the subsequent separation of active and inactive fractions. If separation of floc components is possible, then methods may be incorporated into wastewater treatment plant operations whereby only the inactive fraction of floc is wasted (i.e., of waste activated sludge, WAS), which in turn could increase the overall effective biological solids retention time, leading to increased process robustness with no net increase in reactor size. The results indicate that ultrasonic irradiation of WAS at 800 Wl(-1) followed by 30 min of settling can produce a supernatant with heterotrophic specific oxygen uptake rates (SOURs) of over two times the SOUR measured in the bulk mixed liquor. Under these conditions 26% of the initial heterotrophic activity was recovered within only 11% of the initial volatile mass. Similarly, autotrophic analysis revealed that nitrifying organisms, while sensitive to the effects of ultrasonic irradiation, can be separated from the activated sludge floc and recovered. An irradiation density of 200 Wl(-1) with an exposure time between 1 and 2 min produced a supernatant with a specific ammonia removal rate of over two times the initial mixed liquor rate.

Impacts of reduced sulfur components on active and resting ammonia oxidizers.

While there has been significant research on the nature and extent of the impact of inhibitory reduced sulfur with respect to anaerobic (e.g., methanogenic and sulfidogenic) microbial systems, only limited study has yet been conducted on the comparable effects of soluble sulfides which might occur within aerobic wastewater treatment systems. Admittedly, aerobic reactors would not normally be considered conducive to the presence of reduced sulfur constituents, but there do appear to be a number of processing scenarios under which related impacts could develop, particularly for sensitive reactions like nitrification. Indeed, the following scenarios might well involve elevated levels of reduced sulfur within an aerobic reactor environment: (1) mixed liquor recycle back through sulfide-generating anaerobic zones (e.g., in conjunction with biological nutrient removal processes, etc.), (2) high-level side-stream sulfide recycle via sludge digestion, etc., back to aerobic reactors, and (3) high-level influent sulfide inputs to wastewater treatment facilities via specific industrial, septage, etc., streams. The objective of this study was, therefore, to determine the subsequent metabolic impact of soluble sulfide under aerated and unaerated conditions, focusing in particular on ammonia-oxidizing bacteria due to their critical first-step role with nitrification. The obtained results indicated that, under catabolically active conditions, cultures of ammonia oxidizers were extremely sensitive to the presence of sulfide. At total soluble sulfide concentrations of 0.25 mg l(-1) S, active ammonia oxidation was completely inhibited. However, immediately following the removal of this soluble sulfide presence, ammonia oxidation started to recover; and it continued to improve over the next 24 h. Similar sulfide impact tests conducted with inactive ammonia oxidizers exposed during anaerobic conditions, albeit at higher dosage levels, also revealed that their subsequent aerobic activity would correspondingly be retarded. These results indicated that, after sulfide exposure under unaerated conditions, subsequent aerobic oxidative activity rates rapidly decreased as the soluble sulfide exposure was increased from 0.5 gm l(-1) S to 5 mg l(-1) S and that further reductions in this activity progressively developed as the concentration was increased to 200 mg l(-1) S. The recovery following unaerated exposure to sulfide was significantly higher at pH 7, as compared with pH 8, and although the specific nature of this variation was not established, a hypothetical explanation appeared warranted.

Relationship of beta-cell function and autoantibodies to progression and nonprogression of subclinical type 1 diabetes: follow-up of the Seattle Family Study.

A total of 85 islet cell antibody (ICA)+ or insulin autoantibody (IAA)+ relatives of patients with type 1 diabetes have been followed as part of the Seattle Family Study for a mean of 2.8 years. Of the subjects followed, 10 developed diabetes during this time period. The presence of GAD antibodies was strongly associated with the development of diabetes. In contrast, the presence of IAAs did not influence the risk of diabetes among ICA+ GAD+ subjects. When either the initial absolute acute insulin response to glucose (AIRg) or the AIR percentile, which accounts for the individual's insulin sensitivity, was below the 10th percentile of normal subjects, the risk of diabetes approached 50% at 5 years. However, impaired beta-cell function did not influence the risk of diabetes among those who were GAD+. There were 13 subjects with low AIRg and 13 subjects with two or more antibodies who had not progressed to diabetes during the course of the study. Other measurements of beta-cell function or demographic characteristics were not different in this group of nonprogressors compared with those with low AIRg who did not progress to diabetes. We conclude that ICA+ relatives with GAD antibodies or low AIRg have a high risk for development of diabetes, but among ICA+ GAD+ relatives, the addition of IAA or a single determination of AIRg does not enhance the prediction of diabetes. We suggest that prediction of diabetes risk depends on both the type and the number of antibodies present. In addition, there are a group of ICA+ relatives with low AIRg and/or multiple antibodies who have not progressed to diabetes over the course of the study.

Bilateral orchiectomy with or without flutamide for metastatic prostate cancer.

BACKGROUND: Combined androgen blockade for the treatment of metastatic prostate cancer consists of an antiandrogen drug plus castration. In a previous trial, we found that adding the antiandrogen flutamide to leuprolide acetate (a synthetic gonadotropin-releasing hormone that results in medical ablation of testicular function) significantly improved survival as compared with that achieved with placebo plus leuprolide acetate. In the current trial, we compared flutamide plus bilateral orchiectomy with placebo plus orchiectomy. METHODS: We randomly assigned patients who had never received antiandrogen therapy and who had distant metastases from adenocarcinoma of the prostate to treatment with bilateral orchiectomy and either flutamide or placebo. Patients were stratified according to the extent of disease and according to performance status. RESULTS: Of the 1387 patients who were enrolled in the trial, 700 were randomly assigned to the flutamide group and 687 to the placebo group. Overall, the incidence of toxic effects was minimal; the only notable differences between the groups were the greater rates of diarrhea and anemia with flutamide. There was no significant difference between the two groups in overall survival (P=0.14). The estimated risk of death (hazard ratio) for flutamide as compared with placebo was 0.91 (90 percent confidence interval, 0.81 to 1.01). Flutamide was not associated with enhanced benefit in patients with minimal disease. CONCLUSIONS: The addition of flutamide to bilateral orchiectomy does not result in a clinically meaningful improvement in survival among patients with metastatic prostate cancer.

Bronchoalveolar lavage: radiographic manifestations.

Bronchoalveolar lavage (BAL) is a safe and well-tolerated procedure in which the lower respiratory tract is sampled through infusion and subsequent aspiration of sterile saline solution. To determine the radiographic changes consequent to this procedure, 25 patients undergoing fiberoptic bronchoscopy and BAL were evaluated prospectively. After lavage, anteroposterior radiographs were obtained immediately and after 30, 90, and 240 minutes, and 24 hours. The degree and site of opacification on the radiographs was graded on a 4+ subjective scale. Sixty-nine lobes were lavaged, but owing to overlap on the radiographs, 52 projected areas were evaluable for radiographic changes. Forty-seven areas of consolidation were identified on the radiographs obtained immediately after lavage. Consolidation was homogeneous and always corresponded to a projected site of lavage. There was a positive correlation between initial opacity on the radiograph and the volume of retained fluid (rs = .60, P less than .001). Consolidation cleared gradually over 24 hours. No patient had clinical pneumonitis. These benign, self-limited radiographic changes are common after BAL and may simulate pulmonary edema, aspiration, or hemorrhage.