Faculty Bibliography

He cautioned: 'We don't have all the vaccine we need to meet the possible demand. The critical issue now is: Can we make enough vaccine, given the well-known inability of the vaccine industry to make enough vaccine?' An earlier human vaccine against A(H5N1) avian influenza virus was prepared after it first appeared in Hong Kong in 1997. That vaccine was never fully developed or used, and the strain has mutated since then. In interviews over recent days, [Anthony Fauci] has said that tests so far have shown that the new vaccine produced a strong immune response among the small group of healthy adults under age 65 who volunteered to receive it, although the doses needed were higher than in the standard influenza vaccine offered each year. The vaccine, developed with genetic engineering techniques, is intended to protect against infection, not to treat those who are sick

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

Molecular techniques such as spa typing and multilocus sequence typing use DNA sequence data for differentiating Staphylococcus aureus isolates. Although spa typing is capable of detecting both genetic micro- and macrovariation, it has less discriminatory power than the more labor-intensive pulsed-field gel electrophoresis (PFGE) and costly genomic DNA microarray analyses. This limitation hinders strain interrogation for newly emerging clones and outbreak investigations in hospital or community settings where robust clones are endemic. To overcome this constraint, we developed a typing system using DNA sequence analysis of the serine-aspartate (SD) repeat-encoding region within the gene encoding the keratin- and fibrinogen-binding clumping factor B (clfB typing) and tested whether it is capable of discriminating within clonal groups. We analyzed 116 S. aureus strains, and the repeat region was present in all isolates, varying in sequence and in length from 420 to 804 bp. In a sample of 36 well-characterized genetically diverse isolates, clfB typing subdivided identical spa and PFGE clusters which had been discriminated by whole-genome DNA microarray mapping. The combination of spa typing and clfB typing resulted in a discriminatory power (99.5%) substantially higher than that of spa typing alone and closely approached that of the whole-genome microarray (100.0%). clfB typing also successfully resolved genetic differences among isolates differentiated by PFGE that had been collected over short periods of time from single hospitals and that belonged to the most prevalent S. aureus clone in the United States. clfB typing demonstrated in vivo, in vitro, and interpatient transmission stability yet revealed that this locus may be recombinogenic in a primarily clonal population structure. Taken together, these data show that the SD repeat-encoding region of clfB is a highly stable marker of microvariation, that in conjunction with spa typing it may serve as a DNA sequence-based alternative to PFGE for investigating genetically similar strains, and that it is useful for analyzing collections of isolates in both long-term population-based and local epidemiologic studies

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.

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