Histiocytic necrotizing lymphadenitis in the context of systemic lupus erythematosus (SLE): Is histiocytic necrotizing lymphadenitis in SLE associated with skin lesions?

Histiocytic necrotizing lymphadenitis (HNL), or Kikuchi's disease, is a benign and self-limiting lymphadenopathy that typically affects young Asian females. It presents with lymphadenopathy, usually cervical, accompanied by fever, chills and leukopenia. Although the association between systemic lupus erythematosus (SLE) and HNL is rare, the number of reports of HNL in SLE patients is increasing. We present nine cases of HNL in patients with SLE. Among the seven patients with diverse skin manifestations, three had skin manifestations that were histologically compatible with SLE. A review of previous reports in the literature showed that cutaneous involvement was commonly found in HNL in association with SLE. In the patients who had simultaneous onset of both diseases, lupus flare-ups were commonly observed. We suggest that HNL in SLE patients is associated with cutaneous manifestations. This report contributes to our understanding of the relationship between these diseases.

Prevalence and characterization of Salmonella Gallinarum in the chicken in Korea during 2000 to 2008.

Salmonella enterica serovar Gallinarum (Salmonella Gallinarum) is the causative agent of fowl typhoid (FT), a severe systemic disease of chickens that results in high mortality. Since 1992, FT has become one of the most serious bacterial diseases in poultry in Korea. The purpose of this study was to investigate the prevalence of FT during 2000 to 2008 and characterize the phenotype and genetic diversity of Salmonella Gallinarum isolates before and after adopting national-wide vaccination with a live attenuated strain (SG 9R) in 2001. For 9 yr, a total of 983 farms were affected with FT outbreaks, and after reaching a peak in 2002 (206 farms affected), the prevalence of the disease gradually declined, whereas magnitude sales of the vaccine increased every year. According to the analysis based on the chicken breeds (n=521 farms), the incidence of FT in commercial broilers, Baeksemi (a mixed breed of male meat-type breeder and female commercial layer), commercial layers, native chickens, and broiler breeders was 47.7, 28.4, 17.2, 5.1, and 1.3%, respectively. Of the affected broilers, over 90% birds were under 2 wk of age, indicating it was possible that they were infected with Salmonella Gallinarum via vertical transmission. In the phenotypic analysis, Salmonella Gallinarum strains (n=142) isolated during 2001 to 2007 showed the same pattern in the majority of the biochemical tests such as carbohydrate fermentation and amino acid decarboxylation. Interestingly, all of the strains could not ferment rhamnose, but SG 9R could, making rhamnose a potential biomarker to distinguish the vaccine strain. In analyzing the genetic diversity by the pulsed field gel electrophoresis method with XbaI digestion, we examined a total 68 isolates of Salmonella Gallinarum obtained in 5 provinces in Korea (2001 to 2007). The pulsed field gel electrophoresis profiling produced 7 different patterns, but isolates within the same group did not show clear geographic or breed relationships. In conclusion, there were close epidemiological linkages between prevalence of FT and the sales volume of the live FT vaccine in Korea. In addition, a low phenotypic and genetic heterogeneity was observed among Korean Salmonella Gallinarum isolates and the live vaccine strain (SG 9R).

Outbreak of brucellosis in domestic elk in Korea.

Seven of 18 elk on a deer farm were found by the official Rose-Bengal agglutination test (RBT) and tube agglutination test to be brucellosis reactors/suspects. Evaluation with the competitive ELISA (C-ELISA) and the fluorescence polarization assay (FPA) tests revealed that six and five sera were positive respectively. The seven reactors/ suspects were slaughtered and their blood and tissues were collected. Brucella species could be isolated from three of the slaughtered animals, with nine isolates being obtained from the popliteal, supramammary and submandibular lymph nodes, vaginal discharge, mammary tissue and spleen. Brucella genus-specific PCR based on 16S rRNA and AMOS-PCR, which is specific for differential Brucella species, revealed that all nine isolates were Brucella abortus. These nine were further confirmed to be B. abortus biovar 1 by classical biotyping scheme assays. This is the first report of an outbreak of brucellosis in domestic elk in Korea. Our observations suggest that deer should be included in the routine Brucella surveillance programme for the effective control and prevention of brucellosis in Korea.

Increased expression of soluble inducible costimulator ligand (ICOSL) in patients with systemic lupus erythematosus.

To investigate the level of costimulating molecules in systemic lupus erythematosus (SLE), we assessed the plasma concentrations of soluble forms of costimulatory molecules such as programmed death-1 (PD-1), B7-H1 (also called PD-L1 or CD274) and inducible costimulator ligand (ICOSL) in patients with SLE. Plasma concentrations of soluble PD-1, B7-H1 and ICOSL were measured by ELISA using plasma samples from 57 SLE patients with or without the active disease, 21 rheumatoid arthritis (RA) patients and 35 healthy subjects. We also evaluated surface ICOSL expression on B cells using flow cytometry to gain a better understanding of ICOSL expression. To compare the level of ICOSL mRNA expression, reverse transcriptase-polymerase chain reaction (RT-PCR) was performed using total RNA from peripheral blood mononuclear cells (PBMCs) isolated from eight healthy subjects and 11 patients with SLE. The concentration of plasma ICOSL was significantly higher in patients with SLE compared with healthy subjects (P = 0.005). Plasma ICOSL concentrations in patients with active SLE were also significantly higher than those of either patients with inactive SLE or patients with RA (P = 0.001, P = 0.015, respectively). Plasma ICOSL concentrations in patients with SLE correlated modestly with the SLE disease activity index score (r = 0.298, P = 0.024). We also found a significant inverse correlation between the soluble ICOSL expression and the surface ICOSL expression on B cells (r = -0.690, P = 0.001). However, ICOSL mRNA levels of patients with SLE were comparable with those of the control subjects. There was also no significant difference in plasma B7-H1 concentrations between groups, and plasma PD-1 was not detectable in any of the groups. The plasma concentration of soluble ICOSL might be correlated to the disease severity of lupus. The increased levels of ICOSL in active lupus suggest that this pathway is involved in the pathogenesis of SLE. The mechanism and physiological role of soluble ICOSL in the pathogenesis of SLE, however, remains to be investigated.

Iron porphyrins as models of cytochrome c oxidase.

A series of iron porphyrins has been synthesized as models of cytochrome c oxidase; their activity as 4e catalysts in the reduction of dioxygen has been studied at pH 7. These compounds have been obtained by grafting very different residues onto the same iron complex, namely tripodal tetraamines, pickets, and straps, in order to change the environment of the metal center. In the case of porphyrins bearing a tripodal cap, the secondary amines have been alkylated with different substituents so as to modify the electronic environment of the distal pocket. Surprisingly, when the iron porphyrin is functionalized with four identical acrylamido pickets, the resulting complex exhibits biomimetic activity in that it catalyzes oxygen reduction with almost no production of hydrogen peroxide. The crystal structure of the redox-inactive zinc(II) analogue is reported; this shows how the metal influences the spatial arrangement of the four pickets through axial coordination and hydrogen bonding. Even a bis-strapped iron porphyrin, for which no dimerization or self-aggregation can occur at the electrode surface, acts as a 4e catalyst for O2 reduction. It is thus demonstrated that at pH close to physiological values, the iron porphyrin is an intrinsically efficient catalyst for the reduction of oxygen to water.

Can legislation prevent debauchery? Mother gin and public health in 18th-century England.

The "gin epidemic" of 1720 to 1751 in England was the first time that government intervened in a systematic fashion to regulate and control sales of alcohol. The epidemic therefore provides an opportunity to gauge the effects of multiple legislative interventions over time. Toward that end, we employed time series analysis in conjunction with qualitative methodologies to test the interplay of multiple independent variables, including real wages and taxes, on the consumption of distilled spirits from 1700 through 1771. The results showed that each of the 3 major gin acts was successful in the short term only, consistent with the state's limited resources for enforcement at the local level, and that in each instance consumption actually increased shortly thereafter. This was true even of the Gin Act of 1751, which, contrary to the assumptions of contemporaries and many historians, succeeded by accident rather than by design. The results also suggest that the epidemic followed the inverse U-shaped trajectory of more recent drug scares and that consumption declined only after the more deleterious effects of distilled spirits had been experienced by large numbers of people.

Can alcohol price policies be used to reduce drunk driving? Evidence from Canada.

Drunk driving is one of the more serious negative consequences of alcohol consumption. Since consumption of alcohol is sensitive to the price of alcohol, and the occurrence of drunk driving is sensitive to the level of alcohol consumption, the possibility exists for alcohol pricing policies to be used to reduce drunk driving in the population. This paper reviews the evidence on this possibility in the literature and adds results based on data from the Canadian province of Ontario. Multiple regression analysis of time series data for Ontario from 1972 to 1990 indicate that, controlling for income, the proportion of young males in the population, changes in the minimum drinking age, and other confounding variables, increasing the price of alcohol has a significant effect in reducing alcohol-related motor vehicle accidents (elasticity = - 1.2, p < .05) and alcohol-related traffic offenses (elasticity = -0.50, p < .05). Overall, the evidence strongly supports the view that alcohol tax and pricing policies can be used to reduce the extent of drunk driving.

Privatizing alcohol sales and alcohol consumption: evidence and implications.

AIM: To provide an overview of recent privatization/deregulation experiences in North America and other settings, in order to draw conclusions about the impacts that might be expected from such changes on rates of alcohol consumption and related problems. METHODS: Critical review of research evidence on the effect of changes in availability, particularly changes in physical availability and economic availability that typically accompany privatization of alcohol retail monopolies. FINDINGS: Deregulation/privatization experiences commonly involve higher density of outlets, longer hours or more days of sale, changes in price, a strong orientation to commercial aspects of alcohol sales and the introduction of new vested economic interests into alcohol management arrangements in the jurisdiction. In many instances these changes in access to alcohol are accompanied by an increase in the per capita rates of consumption. In the short term changes in prices are likely to either increase or demonstrate opposite patterns for beverages with different base prices. Longer-term patterns point to a decline in real price with privatization, which very probably stimulates per capita alcohol sales. CONCLUSION: The existing evaluation literature on the subject of privatization has tended to focus on examining the net short-term results in terms of alcohol consumption levels. Overall, there are too few studies employing adequate statistical methodologies to explore the underlying causes of changing alcohol consumption and alcohol-related harm. Finally, seven specific suggestions that may assist future studies are discussed.

Alcohol and all-cause mortality in Europe 1982-1990: a pooled cross-section time-series analysis.

AIM: To test the relationship between alcohol consumption and all-cause mortality. DATA: Yearly mortality rates and per capita consumption from 25 European countries between 1982 and 1990. STATISTICAL MODELS: This paper employs time-series cross-sectional data to model the relationships between alcohol consumption and all-cause mortality. The data are derived from 25 European countries in the 1980s. The statistical analyses controlling cross-sectional correlation and timewise autoregression were used to implement the econometric modelling. FINDINGS: Increases (decreases) in the per capita consumption of 1 litre of pure alcohol were associated with increases (decreases) of 1.3% in all-cause mortality rates. The beverage-specific analyses indicated a significant relationship between consumption of beer and all-cause mortality only. CONCLUSION: The data show that per capita alcohol consumption, according to reported levels in Europe, is related to all-cause mortality and is thus of relevance to public health.

Implications of privatizing/deregulating alcohol retail sales: projections of alcohol consumption in Ontario.

PURPOSE: To project the consequences of privatizing or deregulating current alcohol retail monopolies in Ontario, Canada. METHODS: The projection is based on a multiplicative model and applied to estimate per capita alcohol consumption for four hypothetical scenarios, including both partial and complete privatization for the Province of Ontario, Canada. Those scenarios are mainly focused on the two dimensions of changes affected by privatization: alcohol physical availability and economic availability (i.e., retail prices). Various assumptions involving availability and prices are largely based on the Canadian and international research literature on deregulation/privatization. RESULTS AND IMPLICATIONS: The study showed that per capita alcohol consumption in the short/medium term is expected to increase in all four hypothetical scenarios examined, with the magnitude ranging from 11% to 27%. The sensitivity analysis also revealed a similar increase in alcohol consumption, even though the magnitude of the increase would be less for some scenarios. Therefore, any deliberations on modifying alcohol control policies are well advised to proceed with caution, since an increase in alcohol consumption is likely to be associated with elevated levels of drinking-related problems.

Does allowing the sale of wine in Quebec grocery stores increase consumption?

OBJECTIVE: To determine if allowing wine sales in corner grocery stores, beginning in 1978 for domestic Quebec wines and then in 1983 for imported wines, in addition to sales in government monopoly stores, led to an increase in alcohol consumption. METHOD: Aggregate retail sales data for the period 1953 to 1990 were analyzed using econometric regression techniques. Time series (unit root) analysis and structural modeling were used to take into account the effect of price, income and other social, economic and demographic factors in order to determine the effect of factors underlying consumption behavior in both the long and short term. RESULTS: In the post-intervention period, wine consumption continued along the rising trend established in the pre-intervention period, with an apparent shift in favor of domestic wine consumption. The increase in wine consumption was highest in the period immediately following privatization, but the increase eventually dampened down within a few years. There was no fundamental change in the responsiveness of wine consumption to price. CONCLUSION: Our findings suggest that the level of wine consumption can be controlled through price changes when alcohol availability increases through increased sales outlets.

Hospitalized elders: the difficulties families encounter.

1. Family members encountered difficulties when an elder was hospitalized for an acute episode of a chronic illness. 2. It is important for nurses to recognize the kinds of difficulties that family members experience and develop strategies to alleviate them. 3. Failure to include family members in discharge planning can place elders at risk for readmission to the hospital.