Spotted fever group rickettsiae and in seropositive individuals with or without Lyme disease: A retrospective analysis.

Background: The tick is the main vector of and tick-borne encephalitis virus in Switzerland Spotted fever group Rickettsiae (SFG) and have been detected in Swiss ticks, however, information about the extent and clinical presentation of these infections in humans is scant.

Methods: Indirect fluorescent antibody tests for SFG rickettsiae and were performed on serum samples of 121 seropositive patients with and without Lyme disease and 43 negative controls.

Results: Out of 121 seropositive individuals, 65 (53.

Persistent parvovirus B19 infection and arthralgia in a patient mistakenly treated for Lyme disease.

We report a case of a 37-year-old woman with persistent parvovirus B19 infection and arthralgia mistakenly treated for Lyme disease. This case indicates that poor standardization of both screening and confirmatory assays for Lyme disease can lead to an incorrect diagnosis of Lyme disease. Before making a final diagnosis of Lyme arthritis in an endemic region, other causative agents of arthritis, such as parvovirus B19, should be excluded to avoid unnecessary treatment or to add appropriate therapy in the case of co-infections.

Matrix metalloproteinases in the cerebrospinal fluid of patients with Lyme neuroborreliosis.

Neurologic manifestations of Lyme disease include meningitis, encephalopathy, and cranial and peripheral neuropathy. There are no sensitive markers for neuroborreliosis, and diagnosis is often based on clinical presentation and cerebrospinal fluid (CSF) abnormalities, including intrathecal antibody production. Matrix metalloproteinase (MMP) activity in CSF was compared in patients with neuroborreliosis, patients with diverse neurologic disorders, and healthy controls.

Analyses of 94 consecutive spinal cord injury patients using ASIA definition and modified Frankel score classification.

Serial neurological examinations were analysed on 94 consecutive spinal cord injury (SCI) patients admitted for rehabilitation to the Swiss Paraplegic Center at the Clinic Balgrist Zurich, Switzerland between 1987 and 1992. Patients' data were examined adopting ASIA and modified Frankel definitions in order to compare the two classifications in terms of consistency and prognostic value. The modified Frankel definition was subdivided into five categories (A, B, C, D and E).

[Immunology and diagnostic test results in Lyme borreliosis].

Borrelia burgdorferi (B. burgdorferi), the etiologic agent of Lyme borreliosis, shows both a variety of outer surface proteins with molecular weights between 16 and 100 kiloDalton (kD) and a 41 kD flagellar protein, which induce the immunologic response. Lipopolysaccharides, another constituent of the bacterial capsule, are responsible for the inflammatory reaction, constitutional symptoms and for the Jarisch-Herxheimer reaction.

[Rheumatic fever. Its current status based on 4 cases].

We report on 4 patients with rheumatic fever hospitalized and investigated in our clinics within a 12 month period between 1990 and 1991. In each case a clinically non-severe sore throat preceded the outbreak of rheumatic fever. In three cases diagnosis was according to the revised Jones criteria.

[Arrhythmia and swelling of all extremities].

A 54-year-old patient complained about palpitations secondary to ventricular arrhythmias over a period of several years and severe fatigue for months. Later on arthralgia of the left shoulder and diffuse swelling of both hands and feet appeared. An elevated B.

Perhexiline maleate-induced hepatitis.

We report on a case of perhexiline maleate-induced hepatitis secondary to a long-term administration of recommended daily dosages of 300 mg. The patient had a spectacular weight loss of 29 kg. He developed hepatitis, which subsided after drug withdrawal.

[Paresthesias].

A 23-year-old patient suddenly experienced paresthesia in both legs which progressively ascended to the region of the umbilicus and finally also occurred in all fingers. The physical examination revealed a decreased sensation for touch, discrimination and vibration in all paresthetical regions and on the stem even up to dermatome C5. A mild elevation of the protein content, a mononuclear pleocytosis and oligoclonal bands were found in the cerebrospinal fluid.

[Laboratory chemical analysis in ascites].

Chemical analysis of ascitic fluid may be helpful in determining the underlying disease. We discuss the diagnostic accuracy of the common and newer chemical parameters (protein, LDH, lactate, glucose, cholesterol, triglycerides, phospholipids, fibronectin, albumin gradient [value of serum minus value of ascites], ferritin, tumor markers, immunomodulators, leukocytes, bacterial and cytologic examinations). We also review the pathogenesis and clinical findings of the most frequent ascites forms (benign hepatic, infective, malignant ascites, ascites associated with liver metastases or hepatocellular carcinoma, cardiac and pancreatic ascites) and the most important diagnosis criteria.

Complementary directed modifications of nucleic acids and oncogene-directed mutagenesis in vivo.

High reactivity of the polyalkylating ss oligomers that were sense or antisense 30-200-mers containing sequences complementary to E1 oncogenes of simian adenovirus SA7 and one alkylating residue -CH2CH2N(C2H5OH) (CH2)3N(Ph-p-CH2OH)CH2CH2Cl per each 25 bases of oligomers was demonstrated in vitro by alkylation of ss DNA of recombinant M 13 mp8E1 and mp9E1 phages with inserted E1 sequences of adenovirus oncogene and then by followed complete and selective elimination of E1 sequences from recombinant ss DNA. Treatment of rodent cell cultures transformed by oncogenic SA7 with polyalkylating oligomers which are complementary to the long region of the minus or plus chains of E1 DNA of SA7 revealed a rather high extent of mutant cell clones formation. The cells formed were normalized; they had lost some properties of the transformed cells.

[Persistent leg pain].

A 72 year old patient suddenly experienced severe lumbar pain irradiating into the right leg. Later on, weakness of the muscles thigh appeared. A thorough radiological investigation which showed degenerative alterations of the vertebral column did not supply an explanation.

[Abdominal actinomycosis--ileo-vaginal fistula as clinical manifestation. Case report and literature review].

In 1985 sigmoid resection was performed in an 81-year-old patient with recurrent sigmoid diverticulitis. Due to adenomyosis uteri, hysterectomy was performed at the same time. Approximately one year after an uneventful recovery fetid leukorrhea occurred.

[Diagnostic value of various laboratory parameters in acute pancreatitis].

In 427 samples of serum and urine, collected during their stay at hospital from 40 patients affected with acute pancreatitis, the sensitivity and the specifity of total amylase and lipase in serum, total amylase and pancreas isoamylase in urine, as well as the amylase-/creatinine clearance were determined. The pancreas isoamylase in serum was used as reference value. It appeared that the sensitivity of the lipase was next to that of the pancreas isoamylase in serum, even in limit ranges.

[Semiquantitative lipase determination--a useful screening test for pancreatitis?].

In 233 sera, taken from 112 patients and 20 healthy blood-donors, we have compared RapiTex-Lipase, a semi quantitative immunochemical latex test for the determination of the lipase, with the conventional quantitative method of determination in order to establish its diagnostical value as a screening test for acute pancreatitis. It appeared that, with a positive result of the test increased values of lipase were found in 98% of the cases, but that a negative result of the test did not exclude an increased lipase. The sensitivity of the test as to the quantitative determination of the lipase depended directly on the activity of the lipase and turned out to be acceptable at 88% only with values 4 X higher than the upper limit of the normal range.

[Antibiotic therapy of Lyme borreliosis].

There are still no definite patterns for antibiotic therapy of Lyme borreliosis. Recent studies have shown that ceftriaxone or tetracyclines are superior to the conventional penicillin. Against erythema chronica migrans (stage I) oral therapy, preferably with tetracycline, is sufficient.

[Abdominal actinomycosis. Ileo-vaginal fistula as a clinical manifestation. Case report and review of the literature].

In 1985, a resection of the sigmoid colon was performed on an 81-year-old patient with recurrent and stenotic sigmoid diverticulitis. Vaginal hysterectomy was carried out at the same time for adenomycosis. After an uneventful recovery, approximately 1 year later the patient was presented with fetial leucorrhoea.

[Diagnostic possibilities and limitations in Lyme borreliosis].

In Switzerland 5-35% of Ixodes ricinus ticks are infested with Borrelia burgdorferi (B.b.).

[Tumor markers and immunomodulator substances in ascites--their value as screening and diagnosis parameters].

The object of this study was to determine the known laboratory parameters, tumor markers and immunomodulatory substances in 69 ascites of various etiology, and to test their diagnostic significance. The usual parameters such as protein content, LDH ratio, albumin quotient and albumin gradient, fibronectin, cholesterol and cell count did not reliably differentiate the etiology in each particular case, although the mean values of the various groups differed significantly. Even cytological investigation was negative in 6 out of 29 malignant ascites.

[Diagnostic value of a diagnostic strip for determining urinary amylase].

The semiquantitative determination of amylase in urine with a stick-method has produced controversial results as to its diagnostical significance. In our study we compared the result of the Rapignost-test with the simultaneously measures activity of enzymes (total amylase, pancreatic isoamylase in serum and urine and lipase) in 323 samples of serum and urine taken from 32 patients affected with acute pancreatitis. On the 1st day of hospitalization Rapignost was positive in only 17 out of 32 cases.

[Upper abdominal pain].

We report a female patient in whom the false diagnosis of acute pancreatitis was made, based on intensive epigastric pain and a four fold increase of amylase. The normal values for lipase and decreased values for the urinary amylase were suggestive of a constellation of macroamylasemia. Further investigations revealed a fresh ulcer in the bulbus duodeni as cause of the epigastric pain.

[Extrapancreatic hyperamylasemia. Diagnostic value of isoamylase and lipase determination].

The P- and S-isoamylase and lipase of 72 patients with extrapancreatic hyperamylasemia were determined and their diagnostic value checked to rule out a pancreatic origin. The hyperenzymemia was generally slight although extremely high values were observed in isolated cases. The increased serum amylase results were more often caused by P-, rather than S-isoamylase, while in 28% of cases lipase was also increased.

[Streptococcus bovis bacteremia and colonic diseases].

Four febrile patients were found to have a bacteraemia or endocarditis caused by Streptococcus bovis. Although there were no gastrointestinal symptoms, polyps in the colon, of a high degree of malignancy, were discovered in three. In the fourth, carcinoma of the colon, requiring resection, was found seven years after Streptococcus bovis endocarditis.