A Case Report of Brucellosis and the Differential Diagnosis of Lymphoma and Tuberculosis

ABSTRACT In this paper, we present a male patient from Xinjiang with fever of unknown origin and significant weight loss for more than 1 month. He was admitted to hospital with negative Rose Bengal test (RBT) and decreased leucocyte count. Ultrasound revealed splenomegaly and abdominal computed tomography, which showed multiple hypodense splenic nodules. The patient was suspected of lymphoma or tuberculosis. Pathological biopsy suggested brucellosis infection following splenectomy. Anti-Brucella treatment was effective and his temperature gradually returned to normal. During the follow-up, the patient's RBT result turned to positive and he was instructed to continue the anti-Brucella drug regimen. His temperature, weight, white blood cell count, other laboratory examinations, and imaging findings all returned to normal during the 6-month follow-up after the treatment.

Analysis of the population structure and genetic diversity of the red swamp crayfish (Procambarus clarkii) in China using SSR markers

BACKGROUND: Procambarus clarkii produces high-quality, delicious meat that is high in protein, low in fat, and rich in calcium and phosphorus. It has become an important aquatic resource in China. Our objectives are (i) to analyze the level of genetic diversity of P. clarkii populations; (ii) to explore the genetic differentiation (Gst); and (iii) to propose appropriate strategies for the conservation. RESULTS: In this study, Shannon's index (I) and Nei's gene diversity index (H) for P. clarkii were high (I = 0.3462 and H = 0.2325 on average and I = 0.6264, H = 0.4377 at the species level) based on the SSR markers. The expected heterozygosity value of 17 microsatellite loci in 25 crayfish populations was 0.9317, the observed heterozygosity value was 0.9121, and the observed number of alleles per locus was 2.000; and the effective number of alleles per locus was 1.8075. Among the P. clarkii populations, the inbreeding coefficient within populations (Fis) was 0.2315, overall inbreeding coefficient (Fit) was 0.4438, genetic differentiation coefficient among populations (Fst) was 0.3145 and gene differentiation (Gst) was 0.4785 based on SSR analyses. The cluster analysis results obtained by unweighted pair-group method with arithmetic mean (UPGMA) analysis, principal coordinate analysis (PCoA) and STRUCTURE analysis were similar. A mantel test showed that the isolation-by-distance pattern was not significant. CONCLUSIONS: The high Gst among P. clarkii populations is attributed to genetic drift and geographic isolation. The results indicated that more P. clarkii populations should be collected when formulating conservation and aquaculture strategies.

TP53 codon 72 polymorphism as a risk factor for cardiovascular disease in a Brazilian population

TP53, a tumor suppressor gene, has a critical role in cell cycle, apoptosis and cell senescence and participates in many crucial physiological and pathological processes. Identification of TP53 polymorphism in older people and age-related diseases may provide an understanding of its physiology and pathophysiological role as well as risk factors for complex diseases. TP53 codon 72 (TP53:72) polymorphism was investigated in 383 individuals aged 66 to 97 years in a cohort from a Brazilian Elderly Longitudinal Study. We investigated allele frequency, genotype distribution and allele association with morbidities such as cardiovascular disease, type II diabetes, obesity, neoplasia, low cognitive level (dementia), and depression. We also determined the association of this polymorphism with serum lipid fractions and urea, creatinine, albumin, fasting glucose, and glycated hemoglobin levels. DNA was isolated from blood cells, amplified by PCR using sense 5'-TTGCCGTCCCAAGCAATGGATGA-3' and antisense 5'-TCTGGGAAGGGACAGAAGATGAC-3' primers and digested with the BstUI enzyme. This polymorphism is within exon 4 at nucleotide residue 347. Descriptive statistics, logistic regression analysis and Student t-test using the multiple comparison test were used. Allele frequencies, R (Arg) = 0.69 and P (Pro) = 0.31, were similar to other populations. Genotype distributions were within Hardy-Weinberg equilibrium. This polymorphism did not show significant association with any age-related disease or serum variables. However, R allele carriers showed lower HDL levels and a higher frequency of cardiovascular disease than P allele subjects. These findings may help to elucidate the physiopathological role of TP53:72 polymorphism in Brazilian elderly people.

Tissue-specific regulation of IRS-1 in unilaterally nephrectomized rats

Insulin stimulates the tyrosine kinase activity of its receptor, resulting in the phosphorylation of its cytosolic substrate, insulin receptor substrate 1 (IRS-1). IRS-1 is also a substrate for different peptides and growth factors, and a transgenic mouse "knockout" for this protein does not have normal growth. However, the role of IRS-1 in kidney hypertrophy and/or hyperplasia was not investigated. In the present study we investigated IRS-1 protein and tyrosine phosphorylation levels in the remnant kidney after unilateral nephrectomy (UNX) in 6-week-old male Wistar ratas. After insulin stimulation the levels of insulin receptor and IRS-1 tyrosine phosphorylation were reduced to 79 + 5 percent (P<0.005) and 58 + 6 percent (P<0.0001), respectively, of the control (C) levels, in the remnant kidney. It is possible that a circulating factor and/or a local (paracrine) factor playing a role in kidney growth can influence the early steps of insulin action in parallel. To investigate the hypothesis of a circulating factor, we studied the early steps of insulin action in liver and muscle of unilateral nephrectomized rats. There was no change in pp185 tyrosine phosphorylation levels in liver (C 100 + 12 percent vs UNX 89 + 9 percent, NS) and muscle (C 100 + 22 percent vs UNX 91 + 17 percent, NS), and also there was no change in IRS-1 phosphorylation levels in both tissues. These data demonstrate that after unilateral nephrectomy there is a decrease in insulin-induced insulin receptor and IRS-1 tyrosine phosphorylation levels in kidney but not in liver and muscle. It will be of interest to investigate which factors, probably paracrine ones, regulate these early steps of insulin action in the contralateral kidney of unilaterally nephrectomized rats.

Antibodies in serum of patients with clonorchiasis before and after treatment.

Sera of 31 patients infected with Clonorchis sinensis were examined using fraction 1 antigen by ELISA during a one-year observation. The results of ELISA with Igs, IgG and IgA demonstrated high sensitivity (100%, 100% and 90%) and specificity (100%, 100% and 87%). Sera specific Igs and IgG were significantly decreased in the 3rd month after treatment with praziquantel (25mg/kg body weight in one dose), and IgA was significantly decreased in the 1st month (paired t-test, p < 0.05). No eggs were found in the stool after treatment. Detection of sera specific Igs, IgG and IgA by ELISA was combined with stool examination to evaluate the effect of praziquantel and the completeness of the cure.

Current status of food-borne parasitic zoonoses in Taiwan.

More than 50 species of zoonotic parasites (nematodes-18 spp., trematodes-19 spp., cestodes-10 spp., protozoa-2 spp., and arthropods-2 spp.) have been reported in Taiwan. Among them, Angiostrongylus cantonensis, Clonorchis sinensis and Taenia saginata are the most important and most common food-borne parasites. Angiostrongyliasis is highly endemic in southern and eastern Taiwan. About 80% of patients are children below 15 years of age, mostly infected after eating Achatina fulica during May and September. Patients residing in the mountainous and remote areas are more susceptible than those in the urban districts. Cipangopaludina chinensis and Ampullarium canaliculatus are additional important sources of infection. Albendazole is effective in treating infections in animals. Levamisole has been shown to shorten and lighten the course and symptoms in clinical trials. Clonorchiasis is endemic in Miao-li in northern, Sun-moon lake in central, and Mei-nung in southern Taiwan. Recent surveys, however, have shown endemic areas to be more extensive. Hakkanese and farmers have a greater tendency of infection than other groups. Praziquantel, 3 doses of 20 mg/kg body weight for one day, is an effective treatment. Taeniasis saginata is mainly caused by eating raw beef or viscera of wild animals by the aborigines. A single dose of 150 mg praziquantel cures almost 100%.

Clonorchiasis in Taiwan.

Since Ohi in 1915 found clonorchiasis patients in Taiwan, many surveys have shown that Miao-li in the north, Sun-moon Lake in the middle and Mei-nung in the south of Taiwan are three important endemic areas of clonorchiasis. In recent studies, the disease showed a tendency to extend its endemicity. Rats, cats, dogs and pigs are the natural reservoir hosts, and 17 species of fresh water fish are also infected with metacercaria. One definitive snail host, Parafossarulus manchouricus, and two other suggested snails, Semisulcospira libertina and Thiara granifera, may serve as the first intermediate host. The human incidence is about 20-50% in endemic areas and 10-20% in newly infected localities. Higher infection rates and more intensities of the worm burden are observed in the adult males. A higher incidence is also observed in the Hakkanense ethnic group. The infection according to the occupation has changed from merchants and government employees to farmers. Praziquantel, 60 mg/kg body weight divided into three doses by oral route in one day, has been given to 356 patients and revealed a 96% cure rate and a 99% egg reduction rate. This regimen is highly recommended for the treatment of clonorchiasis.

Clinical studies on angiostrongyliasis cantonensis among children in Taiwan.

Angiostrongyliasis cantonensis is a disease commonly seen in Taiwan, especially in children during the summer rainy season. Most of the cases reported in other countries were adults and their clinical manifestations were different from children. Studies on special clinical characteristics of angiostrongyliasis cantonensis among 82 children in Taiwan were performed. Thirty-eight (46.3%) were male and 44 (53.7%) females, and 87% could be traced to a history of contact with the intermediate host, the giant African snail, Achatina fulica, which plays a major role in transmission. The incubation period (average: 13.2 days) was shorter in children than in adults (average: 16.5 days). In about one-third (30.5%) of the total cases, the clinical form was meningoencephalitis, which was higher than in adult cases seen in Thailand (5%). The most common clinical symptom was fever (91.5%), followed by vomiting and headache. The percentages of sixth and seventh cranial neuropathy associated with the disease were 19.5% and 11.0% respectively. Ophthalmologic fundoscopy showed that 25.0% with papilledema which was significantly higher than seen in adults (12%) in Thailand. Most of the cases in this study had peripheral leukocytosis (above 10,000/mm3) and eosinophilia (above 10%); the percentages were 82.9% and 84.1%, respectively. The worm recovery rate from cerebrospinal fluid by lumbar puncture of 82 cases was 41.5%; 141 worms were collected from one female patient using a pumping method. In the recent 2 years, albendazole and levamisole were used clinically with good result.

Counterimmunoelectrophoresis test on human Clonorchis sinensis infection.

A counterimmunoelectrophoresis test was used to detect antibodies against the adult worm antigen of Clonorchis sinensis in sera from 70 clonorchiasis patients, 20 uninfected healthy persons and 7 patients infected with other helminths. A constant voltage of 10 V/cm and a running time of 30 minutes was chosen in carrying out detection. Antibody titers of 1, 1:2 and 1:4 were obtained from 35, 21 and 14 clonorchiasis patients, respectively. Significant correlation was observed between worm burden in patients and antibody titer, the higher the antibody titer in patients, the more eggs per gram feces in their stool. Although cross reaction was observed with toxocariasis and angiostrongyliasis in this study, high (100%) sensitivity made it possible to screen the subjects in endemic areas to shorten the survey period.

Preparation of monoclonal antibody against Angiostrongylus cantonensis antigen.

Monoclonal antibodies (MAb) against A cantonensis were produced through fusion of immunised spleen cells from BALB/c mice with NS-1 myeloma cells at a ratio of 10:1. The successful fusion rate on the 3rd day of fusion was 90.1%. Ten MAb were characterised, six of which were IgG1 and the remaining four were IgG2a, IgG2b, IgM and IgA respectively. Among 6 IgG1 MAb, four were A. cantonensis-specific, of which three reacted to adult worm antigen only and one reacted to both adult worm and juvenile worm antigens. Two other IgG1 MAb showed cross-reaction with other helminthic antigens of Toxocara canis. Ascaris suum. Paragonimus westermani, Dirofilaria immitis, Anisakis Spp, Gnatostoma Spinigerum and Clonorchis sinensis.