Adipose tissue mitochondrial capacity associates with long-term weight loss success.

OBJECTIVES: We investigated whether (1) subcutaneous adipose tissue (SAT) mitochondrial capacity predicts weight loss success and (2) weight loss ameliorates obesity-related SAT mitochondrial abnormalities. METHODS: SAT biopsies were obtained from 19 clinically healthy obese subjects (body mass index (BMI) 34.6±2.7 kg m-2) during a weight loss intervention (0, 5 and 12 months) and from 19 lean reference subjects (BMI 22.7±1.1 kg m-2) at baseline. Based on 1-year weight loss outcome, the subjects were divided into two groups: continuous weight losers (WL, n=6) and weight regainers (WR, n=13). Main outcome measures included SAT mitochondrial pathways from transcriptomics, mitochondrial amount (mitochondrial DNA (mtDNA), Porin protein levels), mtDNA-encoded transcripts, oxidative phosphorylation (OXPHOS) proteins, and plasma metabolites of the mitochondrial branched-chain amino-acid catabolism (BCAA) pathway. SAT and visceral adipose tissue (VAT) glucose uptake was measured with positron emission tomography. RESULTS: Despite similar baseline clinical characteristics, SAT in the WL group exhibited higher gene expression level of nuclear-encoded mitochondrial pathways (P=0.0224 OXPHOS, P=0.0086 tricarboxylic acid cycle, P=0.0074 fatty acid beta-oxidation and P=0.0122 BCAA), mtDNA transcript COX1 (P=0.0229) and protein level of Porin (P=0.0462) than the WR group. Many baseline mitochondrial parameters correlated with WL success, and with SAT and VAT glucose uptake. During WL, the nuclear-encoded mitochondrial pathways were downregulated, together with increased plasma metabolite levels of BCAAs in both groups. MtDNA copy number increased in the WR group at 5 months (P=0.012), but decreased to baseline level between 5 and 12 months (P=0.015). The only significant change in the WL group for mtDNA was a reduction between 5 and 12 months (P=0.004). The levels of Porin did not change in either group upon WL. CONCLUSIONS: Higher mitochondrial capacity in SAT predicts good long-term WL success. WL does not ameliorate SAT mitochondrial downregulation and based on pathway expression, may paradoxically further reduce it.Data availability:The transcriptomics data generated in this study have been deposited to the Gene Expression Omnibus public repository, accession number GSE103769.

Characterising metabolically healthy obesity in weight-discordant monozygotic twins.

AIMS/HYPOTHESIS: Not all obese individuals display the metabolic disturbances commonly associated with excess fat accumulation. Mechanisms maintaining this 'metabolically healthy obesity' (MHO) are as yet unknown. We aimed to study different fat depots and transcriptional pathways in subcutaneous adipose tissue (SAT) as related to the MHO phenomenon. METHODS: Sixteen rare young adult obesity-discordant monozygotic (MZ) twin pairs (intra-pair difference (∆) in BMI ≥ 3 kg/m(2)), aged 22.8-35.8 years, were examined for detailed characteristics of metabolic health (subcutaneous, intra-abdominal and liver fat [magnetic resonance imaging/spectroscopy]), OGTT, lipids, adipokines and C-reactive protein (CRP). Affymetrix U133 Plus 2.0 chips were used to analyse transcriptomics pathways related to mitochondrial function and inflammation in SAT. RESULTS: Based on liver fat accumulation, two metabolically different subgroups emerged. In half (8/16) of the pairs (∆weight 17.1 ± 2.0 kg), the obese co-twin had significantly higher liver fat (∆718%), 78% increase in AUC insulin during OGTT and CRP, significantly more disturbance in the lipid profile and greater tendency for hypertension compared with the lean co-twin. In these obese co-twins, SAT expression of mitochondrial oxidative phosphorylation, branched-chain amino acid catabolism, fatty acid oxidation and adipocyte differentiation pathways were downregulated and chronic inflammation upregulated. In the other eight pairs (∆weight 17.4 ± 2.8 kg), the obese co-twin did not differ from the non-obese co-twin in liver fat (∆8%), insulin sensitivity, CRP, lipids, blood pressure or SAT transcriptomics. CONCLUSIONS/INTERPRETATION: Our results suggest that maintenance of high mitochondrial transcription and lack of inflammation in SAT are associated with low liver fat and MHO.

Adipocyte morphology and implications for metabolic derangements in acquired obesity.

BACKGROUND: Adipocyte size and number have been suggested to predict the development of metabolic complications in obesity. However, the genetic and environmental determinants behind this phenomenon remain unclear. METHODS: We studied this question in rare-weight discordant (intra-pair difference (Δ) body mass index (BMI) 3-10 kg m(-2), n=15) and concordant (ΔBMI 0-2 kg m(-)(2), n=5) young adult (22-35 years) monozygotic twin pairs identified from 10 birth cohorts of Finnish twins (n=5 500 pairs). Subcutaneous abdominal adipocyte size from surgical biopsies was measured under a light microscope. Adipocyte number was calculated from cell size and total body fat (D × A). RESULTS: The concordant pairs were remarkably similar for adipocyte size and number (intra-class correlations 0.91-0.92, P<0.01), suggesting a strong genetic control of these measures. In the discordant pairs, the obese co-twins (BMI 30.6 ± 0.9 kg m(-2)) had significantly larger adipocytes (volume 547 ± 59 pl), than the lean co-twins (24.9 ± 0.9 kg m(-)(2); 356 ± 34 pl, P<0.001). In 8/15 pairs, the obese co-twins had less adipocytes than their co-twins. These hypoplastic obese twins had significantly higher liver fat (spectroscopy), homeostatic model assessment-index, C-reactive protein and low-density lipoprotein cholesterol than their lean co-twins. Hyperplastic obesity was observed in the rest (7/15) of the pairs, obese and lean co-twins having similar metabolic measures. In all pairs, Δadipocyte volume correlated positively and Δcell number correlated negatively with Δhomeostatic model assessment-index and Δlow-density lipoprotein, independent of Δbody fat. Transcripts most significantly correlating with Δadipocyte volume were related to a reduced mitochondrial function, membrane modifications, to DNA damage and cell death. CONCLUSIONS: Together, hypertrophy and hypoplasia in acquired obesity are related to metabolic dysfunction, possibly through disturbances in mitochondrial function and increased cell death within the adipose tissue.

The cardiac beta-myosin heavy chain gene is not the predominant gene for hypertrophic cardiomyopathy in the Finnish population.

OBJECTIVES: The aim of the study was to screen 36 unrelated patients with hypertrophic cardiomyopathy (HCM; 16 familial and 20 sporadic cases) from a genetically homogeneous area in eastern Finland for variants in the cardiac beta-myosin heavy chain (beta-MHC) and alpha-tropomyosin (alpha-TM) genes. BACKGROUND: Mutations in the beta-MHC and alpha-TM genes have been reported to be responsible for 30% to 40% and less than 5% of familial HCM cases, respectively. However, most genetic studies have included patients from tertiary care centers and are subject to referral bias. METHODS: Exons 3-26 and 40 of the beta-MHC gene and the nine exons of the alpha-TM gene were screened with the PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) method. Linkage analyses between familial HCM locus and two intragenic polymorphic markers (MYO I and MYO II) of the beta-MHC gene were performed in 16 familial HCM kindreds. RESULTS: A previously reported Arg719Trp (arginine converted to tryptophan in codon 719) mutation of the beta-MHC gene was found in one proband and two relatives. In addition, a novel Asn696Ser (asparagine converted to serine in codon 696) substitution was found in one HCM patient. No linkage between familial HCM and the beta-MHC gene was observed in 16 familial kindreds. A previously reported Aspl75Asn (aspartic acid converted to asparagine in codon 175) mutation of the alpha-TM gene was found in four probands and 16 relatives. Mutations in the beta-MHC and alpha-TM genes accounted for 6% and 25% familial HCM cases and 3% and 11% of all cases, respectively. CONCLUSIONS: Our results indicate that the beta-MHC gene is not the predominant gene for HCM in the Finnish population, whereas HCM caused by the Aspl75Asn mutation of the a-TM gene is more common than previously reported.

Variants of the fatty acid-binding protein 2 gene are not associated with coronary heart disease in nondiabetic subjects and in patients with NIDDM.

OBJECTIVE: To investigate the association of variants of the fatty acid-binding protein (FABP) 2 gene with coronary heart disease (CHD) in nondiabetic subjects and in patients with NIDDM. RESEARCH DESIGN AND METHODS: Cross-sectional study included 135 nondiabetic and 79 NIDDM subjects with stenosis (> 50%) in at least two coronary arteries. A group of 81 healthy nondiabetic men without CHD served as a control population. All exons and intron-exon junctions of the FABP2 gene were amplified with the polymerase chain reaction, and variants were screened with the single-strand conformation polymorphism analysis. RESULTS: The allele frequency of an amino acid polymorphism (alanine-->threonine) in codon 54 of exon 2 of the FABP2 gene was 0.26 in nondiabetic subjects with CHD and 0.27 in NIDDM subjects with CHD. Other variants (GTA 118 GTC, GCGCA-->GCACA in the 3'-noncoding region, and the number of ATT repeats in intron 2) also did not associate with CHD. CONCLUSIONS: The variants of the FABP2 gene are not likely to contribute to the risk of CHD in Finnish nondiabetic and NIDDM subjects.

Glucokinase gene islet promoter region variant (G-->A) at nucleotide -30 is not associated with reduced insulin secretion in Finns.

OBJECTIVE: To investigate the effect of the islet promoter region variant (G-->A) at nucleotide -30 of the glucokinase (GCK) gene on insulin levels in subjects with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and NIDDM. RESEARCH DESIGN AND METHODS: The study population included 294 subjects with NGT, 83 subjects with IGT, and 36 subjects with NIDDM. Oral glucose tolerance tests (OGTTs) were performed in all subjects, and intravenous glucose tolerance tests (IVGTTs) were performed in subjects with NGT. The islet promoter region of the GCK gene was amplified with polymerase chain reaction and screened for the variant (-30) using single-strand conformation polymorphism analysis. RESULTS: The islet promoter variant (-30) of the GCK gene was found in 17% of subjects with NGT, 23% of subjects with IGT, and 14% of patients with NIDDM (NS between the groups). Fasting, 1-h, and 2-h insulin levels, measured by OGTT, did not differ between subjects with and without this variant in any of the three groups. Furthermore, first-phase insulin secretion, determined by an IVGTT in subjects with NGT, did not associate with presence of the islet promoter region variant (-30) of the GCK gene. CONCLUSIONS: These results indicate that the variant (-30) of the islet promoter region of the GCK gene does not have a significant effect on insulin secretion in Finnish subjects with NGT, IGT, or NIDDM.

Neonatal immunization: response to Haemophilus influenzae type b-tetanus toxoid conjugate vaccine.

OBJECTIVE: To study the immunogenicity and tolerability of Haemophilus influenzae type b (Hib) conjugate vaccine administered in the neonatal period. DESIGN: Hib capsular polysaccharide (PS)-tetanus toxoid conjugate vaccine (PRP-T) was given to 120 neonates at 2 days of age, followed by PRP-T or the Hib PS vaccine at 4 months and a PRP-T booster at 14 months. Their anti-Hib PS concentrations were compared with those in children receiving PRP-T at 2 and 4 months or at 4 months. RESULTS: No serious adverse reactions were noted. The geometric mean concentration of anti-Hib PS at the age of 2 days was 0.34 micrograms/mL and at 4 months was 0.12 micrograms/mL. This was significantly more than the concentration in unimmunized infants at this age and 3.5 times more than expected, taking into account the natural decay of transplacentally acquired antibodies. Such a response was not seen in infants with a high (greater than 3.0 micrograms/mL) neonatal antibody concentration. The PRP-T vaccine given at 4 months elicited an antibody response in all infants and Hib PS in 62%, indicating immunologic priming. At 14 months, a higher percentage of the infants who had received PRP-T at 2 days and 4 months than of those who had received PRP-T at 4 months only had anti-Hib PS concentrations greater than 0.15 micrograms/mL. All infants responded well to the booster at 14 months. There was no evidence of immunologic tolerance. CONCLUSIONS: Neonatal immunization with PRP-T was safe and well tolerated in Finnish infants, and it would be worthwhile to further study its effects in higher risk populations.

The codon 64 polymorphism of the beta3-adrenergic receptor gene is not associated with coronary heart disease or insulin resistance in nondiabetic subjects and non-insulin-dependent diabetic patients.

Hyperinsulinemia has been shown to predict coronary heart disease (CHD) events in both nondiabetic subjects and patients with non-insulin-dependent diabetes mellitus (NIDDM). Therefore, defects in genes that regulate insulin action could be responsible for an increased risk of CHD. The Trp64Arg polymorphism of the beta3-adrenergic receptor gene has been linked with abdominal obesity, insulin resistance, and early-onset NIDDM. Therefore, we screened for this polymorphism among 185 unrelated nondiabetic subjects (101 men and 84 women; age, 56+/-1 years [mean +/- SEM]; body mass index [BMI], 27.8+/-0.3 kg/m2) with angiographically confirmed CHD (stenosis > 50% in > or = two coronary arteries), among 119 unrelated patients with NIDDM (90 men and 29 women; age, 62+/-1 years; BMI, 28.7+/-0.4 kg/m2; 95 had CHD by the same criteria and 24 had definite myocardial infarction [MI]), and among 82 healthy men (age, 54+/-1 years; BMI, 26.3+/-0.4 kg/m2) from our previous study. The frequency of the Trp64Arg allele of the beta3-adrenergic receptor gene was similar in nondiabetic patients with CHD (8%), NIDDM patients with CHD (7%), and nondiabetic subjects without CHD (7%). No association was found between cardiovascular risk factors and the codon 64 polymorphism of the beta3-adrenergic receptor gene in patients with CHD. Similarly, this polymorphism was not significantly related to insulin resistance in nondiabetic and NIDDM subjects with CHD evaluated by the euglycemic clamp technique. These results indicate that the Trp64Arg allele of the beta3-adrenergic receptor gene does not contribute to the risk of CHD in nondiabetic subjects and NIDDM patients.

Ingredients and contaminants of traditional alcoholic beverages in Tanzania.

Home-made but commercially available alcoholic beverages were collected in Dar es Salaam, Tanzania and analysed for their congener alcohol, additive, aflatoxin and heavy metal contents. Ethanol concentrations of the 15 brewed samples ranged from 2.2 to 8.5% w/v whilst the 2 distilled samples contained ethanol 24.2 and 29.3% w/v. Aflatoxin B1 was found in 9 brewed beverages, suggesting the use of contaminated grain or fruit for their production. The amount of zinc in 4 samples was double the World Health Organization recommended maximum for drinking water (5 mg/litre). One brewed beverage contained toxic amount of manganese (12.8 mg/litre). Both distilled spirits were rich in fusel alcohols and one was fortified by caffeine. The results suggested that impurities and contaminants possibly associated with severe health risks, including carcinogens, are often found in traditional alcoholic beverages. Continuous daily drinking of these beverages is certain to increase health risks. Contaminated grain or fruit rejected from foodstuff production should not be used for the production of alcoholic beverages.

Exposure of tanker drivers to gasoline and some of its components.

The purpose of this study was to measure the exposure of road tanker drivers at work to gasoline and some of its components. The occupational hygiene measurements were made in two depots (one in northern Finland and the other in southern Finland) and in 11 service stations of a Finnish oil company during the loading and delivery of road tankers. Of the 21 measurements made, four were taken during top submerged loading of the road tankers and six during bottom loading at the depot. Eleven measurements were made during delivery at service stations. The duration of measurements varied from 10 to 44 min. The exposure of road tanker drivers to C3-C11 hydrocarbons of gasoline was under 300 mg m-3 during bottom loading measurements and during top loading exceeded 300 mg m-3 two measurements (50%). During delivery at service stations the exposure to C3-C11 hydrocarbons of gasoline exceeded 300 mg m-3 in four measurement (36%). The exposure of road tanker drivers during delivery depended mainly on the distance between working area and the emission point of discharging vapours from the tank, vents and wind direction. The mean exposures of road tanker drivers to benzene during loading and delivery were 1.1-18 mg m-3 in various situations. The mean exposures to n-hexane, to toluene and to xylene were 0.7-6.0, 1.4-11 and 0.8-4 mg m-3, respectively. The exposures to methyl-tert-butyl ether were between 13 and 91 mg m-3. All measurements were made during the summer. However, the temperature varied between 4 and 22 degrees C.

Anti-capsular polysaccharide antibodies reduce nasopharyngeal colonization by Haemophilus influenzae type b in infant rats.

Haemophilus influenzae type b (Hib) conjugate vaccines reduced oropharyngeal carriage of Hib among children in Finland and the United States. To study the mechanisms of this reduction, a colonization model in infant rats with passively administered antibodies was developed. Of the pups, 94% were colonized 48 h and 64% 7 days after intranasal inoculation with approximately 2500 cfu of Hib. Intranasally administered anti-Hib antibodies, including human IgG and both serum and secretory IgA (sIgA) as well as murine monoclonal anti-Hib capsular polysaccharide (PS) of IgG1 isotype, given simultaneously with, before, or after bacteria, significantly reduced nasopharyngeal colonization by Hib. Hib colonization was also significantly reduced when the antibodies were given intraperitoneally, with a resultant anti-Hib PS serum concentration of > or = 7 micrograms/mL. Thus, anti-Hib PS antibodies, both sIgA and IgG, can function on the mucosal surface and prevent colonization.

Occupational asthma in Finland.

In Finland occupational asthma caused by protein allergens and reactive chemicals present in the air of work environments is increasing. This communication describes provocative challenge tests and methods for measuring exposure under simulated work conditions. The importance of lung function measurements during non-exposure and placebo periods is stressed. Especially late reactions are difficult to assess because of the great circadian variation in the lung function parameters of asthmatics. For a positive challenge test, a decrease in peak flow values of at least 15% and a clear deviation from normal circadian variation and placebo periods is required. The allergens of vegetable or animal origin primarily affect patients with an atopic constitution. Chemical allergens seem to attack all exposed workers in the same way. The report lists the occupations with risk for asthma and refers to the population at risk; bakers seem to be the group with the most risk. The importance of early diagnosis, removal of the worker from exposure and improvement of the hygienic aspects of the work environment are stressed.

Detection of polar and macrocyclic trichothecene mycotoxins from indoor environments.

A method is described for the qualitative and semi-quantitative simultaneous determination of both non-macrocyclic and macrocyclic trichothecene biotoxins from samples derived from indoor environments. The method includes extraction, sample pre-treatment and reversed-phase HPLC separation followed by tandem mass spectrometric identification and quantification using electrospray ionization on a quadrupole ion trap mass analyser. Aqueous methanol was used in the initial extraction and solvent partitioning and solid-phase extraction in the purification of samples. The HPLC separation was run on-line with electrospray ionization MS-MS detection. The detection limits and recoveries of the procedure varied from 1 to 1000 pg and from 31 to 92%, respectively. As the method includes few and not very labour intensive sample treatment steps, it should allow for a high throughput of samples with good prospects of automation.

Comparison of tanker drivers' occupational exposures before and after the installation of a vapour recovery system.

The purpose of this study was to compare tanker drivers' occupational exposure level before and after the installation of vapour recovery facilities at 14 service stations. Road tanker drivers are exposed when handling volatile petrol liquid in bulk in the distribution chain. The drivers' exposure was studied during the unloading operation as the bulk petrol flowed into underground storage tanks, displacing vapours in the tank space and causing emission to the environment and the drivers' work area. The exposures were measured again when the dual point Stage I vapour recovery systems were installed for recycling vapours. Short-term measurements were carried out in the drivers' breathing zones by drawing polluted air through a charcoal tube during unloading. The samples were analysed in the laboratory by gas chromatography for C3-C11 aliphatic hydrocarbons, tert-butyl methyl ether (MTBE), tert-amyl methyl ether (MTAE), benzene, toluene and xylene. The road tanker loads delivered consisted of oxygenated and reformulated petrol (E95 and E98 brands), which contained on average 13% oxygenates. Before the installation of the vapour recovery system, the geometric mean (GM) concentration of aliphatic hydrocarbons was 65 mg m-3 (range 6-645 mg m-3) in the drivers' breathing zones. After the installation at the same service stations, the corresponding exposure level was 8.3 mg m-3 (range < 1-79 mg m-3). The GM of the MTBE concentrations was 8.6 mg m-3 (range 1-67 mg m-3) without vapour recovery and 1.5 mg m-3 (range < 0.1-10 mg m-3) with vapour recovery. The differences between the aliphatic hydrocarbons and the MTBE exposure levels during the unloading of the road tankers without and with vapour recovery were statistically significant (p < 0.05).

Customer exposure to gasoline vapors during refueling at service stations.

Gasoline is a volatile complex mixture of hydrocarbon compounds that is easily vaporized during handling under normal conditions. Modern reformulated gasoline also contains oxygenates to enhance octane number and reduce ambient pollution. This study measured the difference in the exposure of customers to gasoline and oxygenate vapors during refueling in service stations with and without vapor recovery systems. Field measurements were carried out at two self-service stations. One was equipped with Stage I and the other with Stage II vapor recovery systems. At Stage I stations there is vapor recovery only during delivery from road tanker, and at Stage II stations additional vapor recovery during refueling. The exposure of 20 customers was measured at both stations by collecting air samples from their breathing zone into charcoal tubes during refueling with 95-octane reformulated gasoline. Each sample represented two consecutive refuelings. The samples were analyzed in the laboratory by gas chromatography using mass-selective detection for vapor components. The Raid vapor pressure of gasoline was 70 kPa and an oxygen content 2 wt%. Oxygenated gasoline contained 7 percent methyl tert-butyl ether (MtBE) and 5 percent methyl tert-amyl ether (MtAE). The geometric mean concentrations of hydrocarbons (C3-C11) in the customers' breathing zone was 85 mg/m3 (range 2.5-531 mg/m3) at the Stage I service station and 18 mg/m3 (range < 0.2-129 mg/m3) at the Stage II service station. The geometric mean of the exposure of customers to MtBE during refueling at the Stage I service station was 15.3 mg/m3 (range 1.8-74 mg/m3), and at the Stage II service station 3.4 mg/m3 (range 0.2-16 mg/m3). The differences in exposure were statistically significant (p < 0.05). The mean refueling times were 57 seconds (range 23-207) at the Stage I and 66 seconds (range 18-120) at the Stage II station. The measurements were done on consecutive days at the various service stations. The temperature ranged from 10 to 17 degrees C, and wind velocity was 2-4 m/s. The climatic conditions were very similar on the measurement days. Based on this study it was found that the Stage II vapor recovery system reduces gasoline emission considerably. The exposure level of customers at the Stage II station during refueling was circa 20-25 percent of the exposure at the Stage I service station when conditions were equal and no other confounding factors such as leaks or spills were present.

Subclass distribution of IgA antibodies in saliva and serum after immunization with Haemophilus influenzae type b conjugate vaccines.

IgA subclass distribution of antibodies against capsular polysaccharide (PS) of Haemophilus influenzae type b (Hib) was studied in saliva and serum samples of children vaccinated with two (n = 58) or three doses (n = 53) of Hib vaccine. One month after the second dose of Hib conjugate vaccine, at 7 months old, 40% of the children had IgA1 and 41% had IgA2 anti-Hib PS antibodies in saliva. One month after the third dose, at 15-25 months old, IgA1 was the predominating subclass; 72% of the children had IgA1, 26% had IgA2 anti-Hib PS in saliva. The mean concentration of IgA1 anti-Hib PS, expressed as optical density (OD) values, was significantly higher after three doses (OD 80.7) than after two doses (OD 18.9). The mean concentration of IgA2 did not change significantly after the third dose (OD 23.8 after two doses, OD 18.1 after three doses). In serum, IgA1 anti-Hib PS predominated both after two (17% had IgA1, none had IgA2) and three doses (72% had IgA1, 4% had IgA2) of Hib vaccine. In conclusion, both IgA1 and IgA2 anti-Hib PS were found in saliva of immunized children after two doses of Hib conjugate vaccine, whereas the third vaccine dose induced a shift towards IgA1 anti-Hib PS dominance in saliva.

Cardiac arrhythmias during occupational exposure to fluorinated hydrocarbons.

The effects of occupational exposure to chlorodifluoromethane (FC 22) and dichlorodifluoromethane (FC 12) on cardiac rhythm were examined. The subjects were six men who repaired refrigerators (age 31-56, mean 46 years) and a control group of six plumbers (age 29-54, mean 45 years). Ambulatory electrocardiograms (ECG) were recorded for 24 hours on the day of exposure and on a control day. The ECG tapes were automatically analysed with a Reynolds pathfinder 3 apparatus and all aberrant complexes recorded by the machine were checked. One person read all the tapes without knowing whether or not they were recorded during exposure. The number of ventricular ectopic beats were compared between the day of exposure and the control day and with the tape of the control. In addition, the number of ventricular ectopic beats during exposure was compared with the number occurring during the rest of the day. The concentrations of fluorocarbons were measured in four instances. High peak concentrations of fluorocarbons (1300-10,000 cm3/m3) were measured during refrigerator repair work. No clear connection between fluorocarbons and cardiac arrhythmia was found, although one subject had several ventricular ectopic beats which may have been connected with exposure.

Immunologic priming by one dose of Haemophilus influenzae type b conjugate vaccine in infancy.

Immunogenicity of one dose of Haemophilus influenzae type b (Hib) conjugate vaccine in infancy and its ability to induce immunologic memory was studied in infants immunized at 4 and 14 months with either PRP-OMP (Hib polysaccharide conjugated with Neisseria meningitidis group B outer membrane protein complex) or PRP-T (Hib polysaccharide-tetanus toxoid conjugate) and compared with three doses of the same vaccines at 4, 6, and 14 months. Each group received diphtheriatetanus-pertusis vaccine at 3, 4, and 5 months of age. At 7 months of age, both vaccines were immunogenic after one dose, even though higher antibody concentrations were achieved after two doses. A booster dose given at 14 months resulted in a high antibody concentration and a strongly IgG-dominated isotype distribution, speaking for a secondary-type response in all groups, including those who had received only one dose in infancy. Subsequent persistence of antibodies suggestive of full protection for up to 36 months was similar in all groups.