Plasminogen activator inhibitor 1, transforming growth factor-beta1, and BMI are closely associated in human adipose tissue during morbid obesity.

In adipose tissue from both obese mice and humans, plasminogen activator inhibitor 1 (PAI-1) expression has been reported to be upregulated to levels of increased plasma PAI-1. This elevated expression has been shown to be partly controlled by tumor necrosis factor (TNF)-alpha in mice. In humans, increased PAI-1 expression is associated with insulin resistance characterized by visceral fat accumulation. Therefore, the aim of this study was to investigate the expression pattern of PAI-1 and TNF-alpha (antigen and mRNA) in visceral human adipose fat in comparison with subcutaneous (SC) fat. Because transforming growth factor (TGF)-beta1 is a potent inducer of PAI-1 synthesis and has been shown to influence adipocyte metabolism, this work was extended to TGF-beta1 quantification. A total of 32 obese individuals (BMI 42 +/- 6.8 kg/m2) were investigated. Freshly collected visceral adipose tissue did not exhibit a higher content of PAI-1 or TGF-beta1 than did SC tissue. Although most of the TNF-alpha values were at the detection limit of the methods, TNF-alpha antigen was 3-fold higher and TNF-alpha mRNA was 1.2-fold higher in visceral fat. The levels of tissue TGF-beta1 antigen correlated well with those of PAI-1 antigen, regardless of the fat depot studied (SC tissue: n = 21, r = 0.72, P = 0.0006; visceral tissue: n = 20, r = 0.49, P < 0.03), and they were both significantly associated with BMI. Conversely, no relationship was observed between the levels of TNF-alpha and PAI-1 or TNF-alpha and BMI. Tissue PAI-1 levels were also significantly correlated with those of circulating PAI-1. These results describe, in severe obesity, a proportional increase in tissue PAI-1 and TGF-beta1 in visceral and SC tissues. This increased PAI-1 expression could be the result of tissue cytokine disturbances, such as elevated TGF-beta1 expression.

[Diphtheria epidemic in eastern Switzerland in 1974]. / Ostschweizer Diphtherie-Epidemie 1974

A diphtheria epidemic in the eastern part of Switzerland in 1974 and the measures which were taken for its management and eradication are described. In particular it is pointed out that at present diphtheria displays atypical clinical symptoms in Europe, a fact that renders the diagnosis very difficult in many cases. Therefore, it is important to perform a throat swab in every patient with suspected diphtheria; it is also necessary to explicitly require a search for C. diphtheriae. The early recognition and early treatment of diphtheria with penicillin or erythromycin is of the utmost importance in order to avoid neurological and cardiac complications. With regard to the management and eradication of a diphtheria epidemic, the most important measures are rapid antibiotic protection of all contacts and a widespread immunization of the population. Vaccination of adults with a DiTe vaccine containing a reduced amount of Di-toxoid is recommanded.

[Epidemiologic relationship of infections with Salmonella typhimurium in Switzerland studied by phage typing (author's transl)]. / Erfahrungen mit der Salmonella typhi-murium-Phagtypisierung zur Abklärung der epidemiologischen Zusammenhänge in der Schwiz

In the area, controlled by the Institute of Microbiology of St. Gall, 262 S. typhi murium strains could be isolated during 1973. By means of phage typing, according to GUINEE, 20 different phage types as well as 6 additional atypically reacting strains, with characteristic atypical pattern, were recognized. The phage type 650 was most frequently encountered (37.0%) folowed by types 61 (20.2%) and 505 (10.3%). An intensive change in phage types was noted among 114 cases, observed over 7 months, in the region of Wil SG. In the beginning, 5 different phage types were determined, but in the following 2 months, they were replaced by the type 650, and, finally, by the type 61. Phage typing enabled the understanding of epidemiologic relationship of two outbreaks occurring in Kirchberg (type 650) and Bütschwil (type 61) by consumption of infected slaughtered beef. Also, an outbreak of the infection in Wil, transmitted by an infected butcher, could be cleared. Testing of the resistance against tetracycline, chloramphenicol, ampicillin and trimethoprim-sulphamethoxazol showed that 80.1% of the strains were sensitive and 18.3% were resistent against tetracycline; some phage types were sensitive (2, 3, 4, 61 etc.), predominantly sensitive (650) or resistent (330, 450, 504, 505 ARS-12). Four strains were resistent against one or more chemotherapeutic agents used.