Faculty Bibliography

The bacteria are commonly found where pigs are raised. Animals without symptoms carry the bacteria in their tonsils and noses. Sichuan Province has one of the largest pig populations in China, and news organizations have reported a concurrent outbreak among pigs in that area. There is no evidence that the illness has been transmitted from one person to another in the outbreak, the health agency said. There was no immediate evidence that China, which came under fire for covering up the outbreak of SARS, or sudden acute respiratory syndrome, in 2002 and 2003, was hiding information about the Streptococcus suis outbreak. Health officials say more laboratory tests are needed to determine why the Sichuan outbreak is so large and the death rate so high. Among the questions infectious disease specialists have raised is whether Streptococcus suis has mutated to become more virulent. Scientists say China should search for other factors that might explain the high death rate. Another unusual feature of the outbreak is that many patients have developed bleeding under the skin, and some have developed toxic shock syndrome

It was the second time in less than a month that [William Rehnquist], 80, went to Virginia Hospital Center because of a fever. He spent two nights at the same hospital in Arlington, Va., after being admitted July 12. The cause of the fever in July was not disclosed. Rehnquist has released only sketchy information about his thyroid cancer, which he disclosed in October. He said he is being treated with radiation and chemotherapy and that surgeons had created a hole in his windpipe, a procedure known as a tracheotomy, to ease his breathing

Chief Justice [William H. Rehnquist] has released only sketchy information about his thyroid cancer, which he disclosed last October. He said that he was being treated with radiation and chemotherapy, and that surgeons had created a hole in his windpipe, a procedure known as a tracheotomy, to ease his breathing. The chief justice did not say what type of thyroid cancer he had. Most patients with thyroid cancer do not need a tracheotomy. The fact that he had the procedure led many thyroid experts not connected with his case to say that they strongly believed that he had anaplastic thyroid cancer, the most aggressive type of that disease

Most cases have occurred among adult male farmers who have had close contact with diseased pigs or have eaten uncooked pig products. The bacteria are commonly found where pigs are raised. Animals without symptoms carry the bacteria in their tonsils and noses. Sichuan has one of the largest pig populations in China, and news organizations have reported a concurrent outbreak among pigs there. Streptococcus suis infections usually occur sporadically, or in small outbreaks, said Dr. Jorgen Schlundt, a Danish veterinarian who directs the department of zoonoses and food borne diseases at the health agency. Zoonoses are infectious diseases that occur primarily in animals but that can be transmitted to people. Health officials say more tests are needed to determine why the Sichuan outbreak is so large and the death rate so high. Among the questions infectious disease specialists have raised is whether Streptococcus suis has mutated to become more virulent. No evidence suggests that the bacteria have become resistant to antibiotics. Scientists say China should search for other factors that might explain the high death rate

In a series of human corticotroph adenomas, we recently found predominant mRNA expression of somatostatin (SS) receptor subtype 5 (sst5). After 72 h, the multiligand SS analog SOM230, which has a very high sst5 binding affinity, but not Octreotide (OCT), significantly inhibited basal ACTH release. To further explore the role of sst5 in the regulation of ACTH release, we conducted additional studies with mouse AtT-20 cells. SOM230 showed a 7-fold higher ligand binding affinity and a 19-fold higher potency in stimulating guanosine 5'-O-(3-thiotriphosphate) binding in AtT-20 cell membranes compared with OCT. SOM230 potently suppressed CRH-induced ACTH release, which was not affected by 48-h dexamethasone (DEX) pretreatment. However, DEX attenuated the inhibitory effects of OCT on ACTH release, whereas it increased the inhibitory potency of BIM-23268, an sst5-specific analog, on ACTH release. Quantitative PCR analysis showed that DEX lowered sst(2A+2B) mRNA expression significantly after 24 and 48 h, whereas sst5 mRNA levels were not significantly affected by DEX treatment. Moreover, Scatchard analyses showed that DEX suppressed maximum binding capacity (B(max)) by 72% when 125I-Tyr3-labeled OCT was used as radioligand, whereas B(max) declined only by 17% when AtT-20 cells were treated with [125I-Tyr11]SS-14. These data suggest that the sst5 protein, compared with sst2, is more resistant to glucocorticoids. Finally, after SS analog preincubation, compared with OCT both SOM230 and BIM-23268 showed a significantly higher inhibitory effect on CRH-induced ACTH release. In conclusion, our data support the concept that the sst5 receptor might be a target for new therapeutic agents to treat Cushing's disease.

OBJECTIVE:Recently, our first clinical study with the novel multiligand somatostatin (SRIF) analogue SOM230 in acromegalic patients showed that SOM230, due to its beneficial inhibitory effects on GH levels compared with octreotide (OCT), might increase the number of patients that can be biochemically controlled. Since SRIF analogues are also known to interact with other metabolic pathways, IGF-I, IGFBP-1, glucose and insulin concentrations on the control day (CD) and on treatment days following a single s.c. injection SOM230 100 and 250 microg, were compared to those following OCT 100 microg. DESIGN AND PATIENTS/METHODS:Randomized, cross-over, double-blinded proof-of-concept trial in 12 patients with active acromegaly. RESULTS:Free IGF-I levels were suppressed after 24 h by OCT, SOM230 250 and 100 microg, whereas at 48 h only both SOM230 dosages still induced these inhibitory effects. Circulating IGFBP-1 levels (AUC; 0830-1430 h) compared with CD, increased sharply after OCT (from 48 to 237 microg/l/h; P < 0.001 vs. CD), while SOM230 250 and 100 microg elicited a lower and dose-dependent effect (163 and 90 microg/l/h, respectively, P < 0.05 vs. CD and OCT). Neither insulin nor GH levels showed statistically significant correlation with IGFBP-1 levels either after SOM230 or OCT. An early rise in glucose levels 1 h postinjection with SOM230 250 microg compared with OCT and CD was observed 8.3 +/- 0.8, 4.4 +/- 0.5 and 4.9 +/- 0.4 mmol/l, respectively: P < 0.05). SOM230 250 microg (19 +/- 4 vs. 46 +/- 3 mU/l on CD: P < 0.05), although clearly less potent than OCT (5.4 +/- 0.4 mU/l: P < 0.01 vs. CD), inhibited insulin release. Since these corresponding absolute insulin levels cannot entirely explain this hyperglycaemic effect of SOM230, other mechanisms seem involved in this glucose rise. If SOM230 would influence glucose homeostasis in peripheral target tissues of insulin action, expression of SS-receptors (sst) seems a logical necessity. In normal human liver tissues, analysed by quantitative polymerase chain reaction (PCR), the average sst1 mRNA expression level appeared significantly higher compared with sst2 (n = 6, relative copy number 161 +/- 46 vs. 57 +/- 6; P < 0.05). Fat tissue expressed both sst1 and sst2 mRNA, whereas in muscle only sst2 mRNA was found. CONCLUSION/CONCLUSIONS:Both dosages of SOM230 inhibit free IGF-I in a more sustained fashion compared to OCT, implying longer duration of action. The superior action of OCT compared with SOM230 in stimulating IGFBP-1 levels, suggests direct regulation of IGFBP-1 by SRIF analogues via sst2. Finally, expression of only sst1 and sst2 in target tissues of insulin action, might point towards additional modulatory effects by SOM230 on glucose homeostasis.

OBJECTIVES: Although human immunodeficiency virus (HIV)-infected patients are now living longer, there are no published data on colorectal cancer (CRC) screening in this population. We hypothesized that HIV-infected patients were less likely to be screened for CRC compared to patients without HIV. METHODS: Consecutive HIV-infected patients > or =50 yr old seen in our outpatient clinic from 1/1/01 to 6/30/02 were identified. For each HIV-infected patient, we selected one age- and gender-matched control subject without HIV infection who was seen during the same time period. The electronic medical records were reviewed to determine the proportion of patients that had a fecal occult blood test (FOBT), flexible sigmoidoscopy, air-contrast barium enema (ACBE), or colonoscopy. RESULTS: During the 18-month study period, 538 HIV-infected outpatients were seen and 302 (56.1%) were > or =50 yr old. Despite significantly more visits with their primary care provider, HIV-infected patients were less likely to have ever had at least one CRC screening test (55.6%vs 77.8%, p < 0.001). The proportion of HIV-infected patients who ever had a FOBT (43.0%vs 66.6%, p < 0.001), flexible sigmoidoscopy (5.3%vs 17.5%, p < 0.001), ACBE (2.6%vs 7.9%, p= 0.004), or colonoscopy (17.2%vs 27.5%, p= 0.002) was significantly lower than in control subjects. In addition, HIV-infected patients were significantly less likely to be up-to-date with at least one CRC screening test according to current guidelines (49.3%vs 65.6%, p < 0.001). CONCLUSIONS: A substantial number of HIV-infected patients are > or =50 yr of age and CRC screening is underutilized in this population. Public health strategies to improve CRC screening in HIV-infected patients are needed.

In order to safely produce a multi-dose vial it is often necessary to add a chemical such as thimerosal. Unfortunately, when the questions about this additive were first raised, vaccine manufacturers did not quickly shift production to another product, Instead, they left themselves open to accusations that they have caused thousands of cases of autism. Thimerosal is not a crucial part of vaccines, it could have been removed long before the current outcry