Biomedical subjects

D A Vuitton

Publications and source records attributed to D A Vuitton.

At least 19 recordsLinked to original sources

PubMed2006

Genotyping of human cystic echinococcosis in Xinjiang, PR China.

The Xinjiang Uygur Autonomous Region, multi-ethnic province in northwestern China, is one of the most important foci of human cystic echinococcosis (CE) in the world. Two Echinococcus granulosus genotypes (G1 and G6) are known to infect the intermediate hosts in this area but, to date, the source of the human infection remains unclear. The current study aimed to genetically analyse 67 hydatid cysts removed from 47 CE patients for which epidemiological, clinical and serological data were also recorded. Mitochondrial cox 1 gene sequencing suggested that the E. granulosus G1 genotype is the major source of infection (45/47 CE patients). Nevertheless, for the first time in China, 2 patients were found with hydatid cysts of the G6 genotype. In addition, 45 E. granulosus gravid tapeworms, isolated from 13 dogs, were genotyped. The majority of adult worms (42/45) exhibited the G1 genotype, whereas 3 adult tapeworms with the G6 genotype were found in one dog, that also harboured E. granulosus tapeworms of the G1 genotype. This sympatric occurrence of G1 and G6 genotypes of E. granulosus, not only in the same area but also in the same definitive host, raises the interesting question of putative genetic recombination between these E. granulosus genotypes.

Adolescent↗

PubMed2006

[Mixed infection of Echinococcus granulosus and Echinococcus multilocularis in dog].

OBJECTIVE: To identify mixed infection of Echinococcus granulosus and E. multilocularis in a dog from Xinjiang. METHODS: Thirty dogs from the pasture area were dissected and over 10,000 Echinococcus adult worms were found from one dog. Morphological observation revealed possible mixed infection of the two Echinococcus species. Further identification was made by amplification of the target gene DNA fragment (mitochondrial 12S rRNA gene). RESULTS: The adult worms of E. granulosus showed a relatively longer and larger gravid proglottid, its genital pore situated near or below the middle-side of the segment. The uterus was in a sacculate shape with irregular branches and approximately over 200 - 800 eggs in it. Morphology of the adult worms of E. multilocularis was similar to E. granulosus, slightly smaller, consisting of 4 to 5 proglottids. The uterus was not sacculate and with no branch. Its lateral genital pore often situated in the anterior part of the segment. Sequence analysis of mitochondrial 12S rRNA gene showed that amplification with the Eg1f/r primers shared complete identity with E. granulosus G1 genotype (GenBank accession no. AY462129), while that witht the EmH15/17 primers shared complete identity with E. multilocularis (GenBank accession no. AB031351). The presence of both E. granulosus and E. multilocularis was confirmed by microscopy and gene identification. CONCLUSION: Mixed infection of the two species of Echinococcus has been confirmed in the dog by morphological observation and PCR technique.

Animals↗

PubMed2006

Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China.

A comprehensive study of human echinococcosis (caused by Echinococcus granulosus or E. multilocularis), including assessment of hospital records, community surveys and patient follow-up, was conducted in Ningxia Hui Autonomous Region (NHAR), China. In contrast to hospital records that showed 96% of echinococcosis cases were caused by cystic echinococcosis (CE), 56% of cases detected in active community surveys were caused by alveolar echinococcosis (AE). The AE and CE cases co-existed frequently in the same village, even occurring in the same patient. A serious public health problem caused by echinococcosis was evident in southern NHAR, typified by: a long diagnostic history for both AE and CE (7.5 years) compared with a shorter treatment history (4.7 years); a significant mortality rate (39%) caused by AE in one surveyed village, where patients had no previous access to treatment; family aggregation of CE and AE cases; a high proportion of both AE (62.5%) and CE (58%) in females; a high rate of recurrent surgery (30%) for CE demonstrated by surgical records; and frequent symptomatic recurrences (51%) because of discontinuous or sporadic access to chemotherapy for AE. The disease burden for both human AE and CE is thus very severe among these rural communities in NHAR, and this study provides the first attempt to determine the costs of morbidity and surgical intervention of human CE and AE cases both at the hospital and community level in this setting. This information may be useful for assessing the cost effectiveness of designing effective public health programs to control echinococcosis in this and other endemic areas in China and elsewhere.

Adolescent↗

PubMed2005

Brain metastasis of alveolar echinococcosis in a hyperendemic focus of Echinococcus multilocularis infection.

An unusual female case, with alveolar echinococcosis (AE) disseminated from the primary hepatic lesion to the brain by metastasis formation, was retrospectively identified during a community survey in Ningxia Hui Autonomous Region, northwest China in 2003. Among possible metastases of hepatic AE, locations to the brain are rare and usually fatal; and they have especially been assigned to concomitant immune suppression. An enhancing role of pregnancy, which may be suspected in this case, the favourable outcome after surgery and chemotherapy, and also a mental disability in a child following long-term intrauterine exposure to mebendazole, make the report particularly unique.

Abnormalities, Drug-Induced↗

PubMed2004

Serum sIL-2R, TNF-alpha and IFN-gamma in alveolar echinococcosis.

AIM: to approach the relationship between alveolar echinococcosis (AE) pathology and level of sIL-2R,TNF-alpha and IFN-gamma in sera and the significance of cytokines in development of AE. METHODS: After 23 patients with AE were confirmed by ELISA and ultrasound, their sera were collected and the concentrations of sIL-2R,TNF-alpha and IFN-gamma were detected by double antibody sandwich. Twelve healthy adults served as controls. According to the status of livers of AE patients by ultrasound scanning, they were divided into 4 groups: P(2), P(3), P(4) groups and C group (control). Average of concentrations of sIL-2R,TNF-alpha and IFN-gamma in homologous group was statistically analyzed by both ANOV and Newman-Keuls, respectively. RESULTS: The mean of sIL-2R in P(2) group was 97+/-29, P(3): 226+/-80, P(4): 194+/-23 and control group (111+/-30)X10(3) u/L (P<0.01). The mean of TNF-alpha in P(2) group was 1.12+/-0.20, P(3): 3.67+/-1.96, P(4): 1.30+/-0.25 and control group 0.40+/-0.19 mug/L (P<0.01). The mean of IFN-gamma in P(2) group was 360+/-20, P(3): 486+/-15, P(4): 259+/-19 and control group: 16+/-2 ng/L (P<0.01). Judged by ANOV and Newman-Keuls, the mean concentrations of sIL-2R, TNF-alpha and IFN-gamma had a significant difference among groups. Except for P(2) group, the mean sIL-2R between other groups of AE patients had a significant difference (P<0.05). The mean of TNF-alpha concentration in P(3) group was the highest (P<0.01). The mean of IFN-gamma concentration in all patients was higher than that in control group (P<0.01), but there was no difference between AE groups (P>0.05). CONCLUSION: Low sIL-2R level indicates an early stage of AE or stable status, per contra, a progression stage. Higher level of TNF-alpha might be related to the lesion of liver. The role of single IFN-gamma is limited in immunological defense against AE and it can not fully block pathological progression.

Adult↗

PubMed2004

Echinococcus granulosus strain typing in North Africa: comparison of eight nuclear and mitochondrial DNA fragments.

Recent studies of Echinococcus granulosus molecular strain typing have enabled a better understanding of the transmission cycle of cystic echinococcosis. There have been many publications in this area but there is a need for the evaluation of these tools. We have attempted to respond to this need in our study, which assessed 8 DNA fragments of 40 E. granulosus cysts from North Africa. Parasitological material was collected from 5 types of intermediate hosts, in 5 different countries. The primers chosen to amplify DNA targets were defined either in nuclear DNA, or in mitochondrial DNA. After amplification, PCR products were sequenced. The sequences obtained were aligned and comparisons were made within the group and with GenBank sequences. Whether the target was nuclear or mitochondrial, the same 2 main groups of genotypes were found. The first one, the 'sheep' strain, was found in the human, sheep and cattle samples collected in North Africa. The second one, the 'camel' strain, was found in the camel cysts and cattle and human cysts from Mauritania. These findings further confirm the congruence of the data given by the nuclear and the mitochondrial genome.

Africa, Northern↗

PubMed2004

Epidemiology of alveolar echinococcosis in southern Cantal, Auvergne region, France.

Alveolar echinococcosis (AE) is a helminth zoonosis which is encountered only in the northern hemisphere. In central France, the Auvergne region represents the most western and southern extension of this helminthiasis. In 1999, a human case of AE was diagnosed in the southern part of the Cantal department, where AE was supposed absent, and an epidemiological survey was subsequently carried out. The transmission of the zoonosis in the sylvatic and peridomestic definitive hosts was studied, as well as that in the rodent and human intermediate hosts. Eleven red foxes (Vulpes vulpes) were shot, and 50 fox faecal deposits were collected. Twelve farm dogs had their faeces taken by rectal touch, and four were checked after arecoline purgation. Optical detection of Echinococcus multilocularis worms was achieved on fox intestines after scraping, and also on dog stools after arecoline therapy. Coproantigen ELISA assay was performed for the 11 scraping products, for the 50 fox faeces, and for the 12 dog faecal samples. No adult AE agent was observed by microscopy, and the ELISA assay yielded positive results in one of 11 fox intestines, one of 50 fox faeces, and 2 of 12 dog faecal samples. Twenty-five small mammals were trapped, of which 19 were Arvicola terrestris water voles. One rodent liver exhibited a hepatic lesion consistent with AE. An epidemiological questionnaire was completed in 85 human volunteers, who were also serologically tested for AE. Only one (the case's husband) exhibited a Western-blotting pattern indicative of a low-grade AE infection. The results of this preliminary study suggested a slow AE extension to the south of Cantal department from the northern focus.

Aged↗

PubMed2003

Cystic echinococcosis in Algeria: cattle act as reservoirs of a sheep strain and may contribute to human contamination.

In Algeria, cystic echinococcosis (CE) is a serious economic and public health problem. The common sheep/dog cycle is usually considered as the major source of human contamination. But to date the main strain of Echinococcus granulosus involved in the human contamination and the role of other hosts are still unknown. This paper reports an original work performed in northern Algeria combining field observations and molecular analysis. In a first step, examination of 6237 carcasses in slaughterhouses showed high infection and fertility rates in cattle and dromedaries. Then, in a second step, we used a molecular biology approach to identify the E. granulosus strain(s) involved. Forty-six samples from various origins were collected. They were analysed using comparison of PCR-amplified DNA sequences with one genomic (BG 1/3) and two mitochondrial (COI and NDI) targets. Results show the presence of a "sheep" strain of E. granulosus in North Algeria circulating between cattle and ovines and infectious to humans, whereas in South Algeria, a "camel" strain and a "sheep" strain were found to circulate in camels and in sheep, respectively. This study also reports an ambiguous genotype which resembled the "sheep" strain genotype (Gl) on the basis of the partial COI gene sequence, whereas on the basis of the partial NDI gene sequence, it was similar either to the "sheep" strain (Gl) or to the "camel" strain (G6). Besides its basic interest, our study confirms the role of other hosts (mainly cattle) in leading to transmission to humans and suggests that control measures should not only target sheep.

Algeria↗

PubMed2003

[A regional public health research network INSERM "PRISMAL" (perception, representation and risk management in rural health settings)].

The PRISMAL (Perception, representation and health risk management in rural settings) network comprises three academic research teams, two health insurance agencies, and two health care networks in the Franche-Comté region that share their expertise to study the relationship between health and the rural environment. Three main objectives guide the network's activities and are linked to the following questions: 1) What are the epidemiological changes linked to the rural setting; what are their causes and effects? 2) What are the relationships between the rural environment, health risks, behaviours in seeking health care, access to health care services and quality of life? 3) What are the perceptions and representations of the affected populations on health risks specific to the rural setting? Research activities utilise specific diseases as examples of the result from interaction with the rural environment, such as "farmer's lung", alveolar echinococcosis, occupational risks for farmers, lung cancer, suicide attempts, premature birth, and vascular stroke. The partnership's framework extends well beyond the medical world and includes ecologists, geographers, sociologists, administrators and environmental technicians.

Agriculture↗

PubMed2003

[Study on CD4+ cells deletion mechanism in experimental alveolar echinococcosis].

OBJECTIVE: To study the possible mechanism of CD4+ T cells deletion in mice with alveolar echinococcosis, particularly on the relationship between Echinococcus multilocularis infection and apoptosis of T lymphocyte subsets. METHODS: BALB/c mice were infected with E. multilocularis and uninfected mice were used as control group. CD4+ T cell and CD8+ T cells were separated 12 weeks and 25 weeks after infection. Purified CD4+ and CD8+ T cell subsets were cultured in complete medium and stimulated with EmAg, anti-CD3 mAb, rIL-2, mouse rTNF alpha and PWM respectively. After 16 h of incubation, cells were collected and assessed by electron microscopy. DNA fragmentation was observed by eletrophoresis, stained by TUNEL assays and PI, analyzed by flow cytometry. RESULTS: CD4+ and CD8+ T cells in 25 weeks experiment group presented chromatin condensation, lost nuclear membrane integrity, and formed exocytoplasmic vacuolization. DNA ladder was observed by agarose gel eletrophoresis, and the appearance of DNA fragments was equivalent to approximately 200 bp. None of these appearances were observed in control group in 12 weeks post infection and CD8+ T cell in mice of 25 weeks post infection group. The apoptosis level of CD4+ and CD8+ T cells in 12 weeks post infection group was not significantly different from the control group. While the apoptosis level of CD4+ and CD8+ T cells increased significantly in 25 weeks post infection group as compared with the control (P < 0.01). Higher apoptosis in CD4+ T cells was observed than that of CD8+ T cells. Apoptosis mainly appeared during S phase of cell cycle. CONCLUSION: Apoptosis is a prominent causation of activation-induced CD4+ T cell death in later period of E. multilocularis infection. Increase of the death-promoter signals and decrease of the death suppresser signals may have been responsible, in part, for the apoptosis in CD4+ T lymphocytes in the infected mice.

Animals↗

PubMed2003

Epidemiology of alveolar echinococcosis with particular reference to China and Europe.

Human alveolar echinococcosis (AE), caused by the metacestode of the fox tapeworm Echinococcus multilocularis, is the most pathogenic zoonosis in temperate and arctic regions of the northern hemisphere. Prospective collection of human cases in some areas and mass screenings using ultrasound imaging and confirmation with serological techniques have markedly improved our knowledge of the epidemiology of the disease in humans during the past two decades. Transmission occurs when eggs of the tapeworm, excreted by the final hosts (usually foxes but also dogs, wolves and cats), are ingested accidentally by humans or during normal feeding by a variety of rodents and small lagomorphs. However, the species of host animals differ according to regional changes in mammalian fauna. This review mostly focuses on epidemiology of alveolar echinococcosis in those parts of the world where new and more accurate epidemiological data are now available, i.e. China and Europe, as well as on new epidemiological trends that can be suspected from recent case reports and/or from recent changes in animal epidemiology of E. multilocularis infection. The People's Republic of China (PRC) is a newly recognized focus on AE in Asia. Human AE cases were firstly recognized in Xinjiang Uygur Autonomous Region and Qinghai Provinces at the end of 1950s and infected animals were first reported from Ningxia in central China and northeast of Inner Mongolia in the 1980s. E. multilocularis (and human cases of AE) appears to occur in three areas: (1) Northeastern China (northeast focus): including Inner Mongolia Autonomous region and Heliongjiang Province (2) Central China (central focus): including Gansu Province, Ningxia Hui Autonomous Region, Sichuan Province, Qinghai Province and Tibet Autonomous Region and (3) Northwestern China: including Xinjiang Uygur Autonomous Region, bordered with Mongolia, Russia, Kazakhstan and Kyrgyzstan. The highest prevalence of the disease, up to 15 per cent of the population in some villages, is reached in China. In Europe, data from the European Echinococcosis Registry (EurEchinoReg: 1982-2000) show 53 autochthonous cases of AE in Austria, 3 in Belgium, 235 in France, 126 in Germany, 1 in Greece, and 112 in Switzerland, and 15 'imported' cases, especially from central Asia; 14 cases were collected in Poland, a country not previously considered endemic for AE. Improved diagnostic technology, as well as a real increase in the infection rate and an extension to new areas, can explain that more than 500 cases have been reported for these 2 decades while less than 900 cases were published for the previous 7 decades. New epidemiological trends are related to an unprecedented increase in the fox population in Europe, to the unexpected development of urban foxes in Japan and in Europe, and to changes in the environmental situation in many countries worldwide due to climatic or anthropic factors which might influence the host-predator relationship in the animal reservoir and/or the behavioural characteristics of the populations in the endemic areas.

Adolescent↗

PubMed2003

Interactions between landscape changes and host communities can regulate Echinococcus multilocularis transmission.

An area close to the Qinghai-Tibet plateau region and subject to intensive deforestation contains a large focus of human alveolar echinococcosis while sporadic human cases occur in the Doubs region of eastern France. The current review analyses and compares epidemiological and ecological results obtained in both regions. Analysis of rodent species assemblages within quantified rural landscapes in central China and eastern France shows a significant association between host species for the pathogenic helminth Echinococcus multilocularis, with prevalences of human alveolar echinococcosis and with land area under shrubland or grassland. This suggests that at the regional scale landscape can affect human disease distribution through interaction with small mammal communities and their population dynamics. Lidicker's ROMPA hypothesis helps to explain this association and provides a novel explanation of how landscape changes may result in increased risk of a rodent-borne zoonotic disease.

Animals↗

PubMed2003

[Kinetic analysis of cytokines and immunoglobulin G subclass in BALB/c mice infected with Echinococcus alveolaris].

OBJECTIVE: To observe the dynamic change of immune response in mice infected with Echinococcus alveolaris (AE) at difference period of time, and to explore hostalveo's immune regulation. METHODS: The infection lasted and was followed up for 25 weeks. The spleen cells from BALB/c mice infected with AE stimulated with EmAg and ConA or PHA in vitro. IL-2R, IFN-gamma, TNF-alpha, IL-1 and specific IgG subclasses were determined by ELISA. NO was tested by chemical assay. RESULTS: NO level sharply rose in 16 weeks after BALB/c mice were infected with AE. The levels of IgG1 and IgG3 significantly increased 8 weeks after infection, and remained elevating throughout the period of observation. IgG3 showed slight increase, IgG2a and IgG2b appeared low level following infection. The production of IL-2R and TNF alpha increased significantly 8 weeks of infection, while IL-2R sharply decreased in 12 weeks of infection. During the period of 2-12 weeks of infection there was an increase in IL-1 secreting. The level of IL-1 and TNF alpha rapidly increased since 16 weeks post infection. High level of IFN-gamma was detected during the period of observation, and showed a peak at 12 weeks. CONCLUSION: Th1 is the major response in the early stage of infection, which is replaced by Th2 response in later period of infection.

Animals↗

PubMed2001

[Echinococcoses].

Human echinococcoses, cystic echinococcosis and alveolar echinococcosis are due to infections with the cestodes Echinococcus granulosus and E. multilocularis, respectively. Both zoonoses share a prolonged latency period before clinical presentation. However their evolution is fairly different: that of a begin tumor of the liver or lung for cystic echinoccocosis, and that of a slowly developing malignant tumor of the liver for alveolar echinoccocosis, with subsequent invasion of liver vessels and bile ducts and metastatic dissemination. Ultrasonography, CT-scan and specific serology are the key-exams for diagnosis. In both forms, surgery is the treatment of choice when a complete resection is possible. Liver transplantation may be an ultimate treatment option in very advanced cases of alveolar echinoccocosis. However, alternative treatment procedures have been proposed in the past 15 years and, combined with an earlier diagnosis, they have markedly improved patients survival and quality of life. Interventional radiology (puncture, aspiration, injection, reaspiration) has become a fully validated treatment of cystic echinoccocosis, and may be used in alveolar echinoccocosis for alleviating some of the complications of the disease such as biliary obstruction or bacterial superinfection. Albendazole, at high dosage, is a necessary complementary treatment after any intervention procedure, and for life when radical resection is not possible. Prevention relies on personal measures of hygiene and heating of contaminated food, and on collective measures aimed at reducing cestode egg shedding by the feces of infected canivores.

Abdominal Pain↗

PubMed2001

Assessment of the epidemiological status of Echinococcus multilocularis in foxes in France using ELISA coprotests on fox faeces collected in the field.

The aim of this study was to estimate the relevance of Echinococcus multilocularis coproantigen detection in fox faeces collected in the field to identify different levels of endemicity for Echinococcus multilocularis on a large scale (n x 10 km(2)). Six study sites were selected in a high endemicity area and two study sites in a low endemicity area in eastern France on the basis of landscape composition. Sampling was undertaken in the winters of 1996-97, 1997-98 and 1998-99. At each site, (i) necropsy and intestine examination was undertaken on a sample of shot foxes (total number of foxes, 222), and (ii) fox faeces were collected in the field along road verges, and scored for degradation status (total number of faeces, 625). Fox faeces were also sampled in a control area (n=30) in western France in the summer of 1998. Intestines were examined according to the sedimentation method. Echinococcus multilocularis coproantigens were detected by using two ELISA tests: EM-ELISA and EmA9-ELISA. The necropsy prevalence in high and low endemicity areas was 63.3% and 19.4%, respectively, and the distribution of adult worms in the fox population was highly overdispersed (75.5% of the total biomass was harboured by 11.6% of foxes). Using the two ELISA tests, there was no difference in the detection of E. multilocularis coproantigens in field faeces, regardless of the degradation status. The medians of EM- and EmA9-ELISA OD values of field faeces in high endemicity area were significantly higher than in low endemicity area (P<0.001 for both ELISA). The distribution of EM-ELISA OD values in low endemicity area was significantly higher (P=0.002) than in the control area. Moreover, for the two ELISA, the observed ELISA OD value distributions in high endemicity area, low endemicity area and control area seemed representative of the distribution of adult worms in fox populations. These results indicate that E. multilocularis coproantigen detection in field faeces could serve for large-scale surveillance, as an alternative to necropsy.

Animals↗

PubMed2001

Transglutaminase-mediated cross-linking is involved in the stabilization of extracellular matrix in human liver fibrosis.

BACKGROUND/AIMS: Lysyl oxidase-mediated cross-linking contributes to the stabilization of collagen in liver fibrosis. We have investigated transglutaminase-mediated cross-linking, to determine if it participates in the stabilization of extracellular matrix in human liver fibrosis. METHODS: Transglutaminase activity was assessed in vitro by incorporation of biotinylated amine into liver proteins. The product of the transglutaminase-catalyzed cross-linking reaction, Nepsilon(gamma-glutamyl)lysine, and the extracellular proteins cross-linked by it, were localized by immunohistochemistry in fibrotic livers. The cross-linked complexes were extracted from liver tissue, immunopurified and characterized by Western blot. RESULTS: Transglutaminase, detected by immunohistochemistry, Western blot and by enzymatic activity, was found in higher amounts in fibrotic than in normal liver. The Nepsilon(gamma-glutamyl)lysine cross-link, undetectable in normal liver, was present extracellularly in fibrotic liver, where it was co-distributed with osteonectin, mostly in inflammatory areas submitted to an intense remodeling. Cross-linking of osteonectin by transglutaminase was confirmed by Western blot. In parasitic fibrosis transglutaminase also originates from the parasite. CONCLUSIONS: Transglutaminase-mediated cross-linking occurs in liver extracellular matrix during the early, inflammatory, stage of liver fibrosis, whereas cross-linking by pyridinoline occurs mostly later in the fibrotic process. This could lead to the development of new anti-fibrotic treatments targeted to a specific stage of fibrosis.

Cross-Linking Reagents↗

PubMed2001

[Myelodysplasias and systemic diseases. A non-fortuitous association].

PURPOSE: Myelodysplastic syndromes are clonal hematologic disorders, expanded from myeloid stem cells. A primitive immunologic disorder is discussed. This hypothesis could explain a non-casual association with systemic diseases. The aim of our study is to test this hypothesis. METHODS: We retrospectively investigated the data of 60 patients with myelodysplastic syndromes (group I) hospitalized in our unit from 1990 to 1999. The frequency of systemic disorders was screened and compared to controls (group II). Group II consisted of 120 patients matched for age and sex and hospitalized in the same hospital during the same period. RESULTS: Sixty patients were included (mean age: 83 years old). Myelodysplastic syndrome subtypes were refractory anemia with excessive blasts (52%), refractory anemia (43%) and sideroblastic anemia (5%). Fourteen cases of systemic manifestations were reported in group I (23%) and five in the controls (4%) (P < 0.0001). Systemic manifestations in group I included vasculitis in six cases (42%), polyarthritis in three cases (21%), systemic amyloidosis AA in two cases (14%), relapsing polychondritis in one case, pyoderma gangrenosum in one case and celiac disease associated with a systemic granulomatosis in one case. In the controls, vasculitis was present in four cases and polyarthritis in one. Median age at onset of myelodysplastic syndrome was not influenced by the association with systemic disorders which, in return, have not influenced the myelodysplastic syndromes' subtypes. Myelodysplastic syndromes succeeded to systemic manifestations in 71.4% of cases and could not be attributed to immunosuppressive therapy. CONCLUSIONS: The association of myelodysplastic syndromes with systemic manifestations seems not to be casual. It raises the hypothesis of a primitive immunological disorder in both diseases. Moreover, the description of two cases of systemic amyloidosis and one case of pyoderma gangrenosum might suggest an additional disorder of macrophages or granular cells.

Age of Onset↗

PubMed2000

An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China.

Human alveolar echinococcosis (AE) is usually a rare, highly pathogenic zoonotic disease, transmitted across the northern hemisphere between fox and rodent hosts. In China the first cases were described in 1965; however very few epidemiological studies have been undertaken since. Following identification in 1991 of a serious focus of human AE in south Gansu province, detailed village-based community and ecological studies were carried out between 1994 and 1997. Hepatic ultrasound mass screening with serological testing (five tests) identified 84/2482 new AE cases (3%). An overall prevalence of 4.1% (135/3331) was recorded for the area when previous cases were also included. Based on a seropositive result only, without an ultrasound scan indication, no additional AE cases were identified. Of the evolutive AE cases, 96% were seropositive in at least one test, while up 15-20% of individuals who exhibited hepatic calcified lesions and 12-15% exhibiting hepatic nodular lesions were seropositive for specific Em2 or Em18 antibodies. Village (n=31) human AE prevalence rates varied from 0 to 15.8%. Questionnaire analysis indicated that total number of dogs owned over a period was a risk factor (P<0.006), but not a history of red fox hunting (P>0.6). Rodent ecology studies revealed an association between density indices of voles (Microtus limnophilus) and village AE prevalence rates, on the one hand, and village landscape characterised by a ratio of scrub/grassland to total area above 50% (P<0.005). Long-term transmission of Echinococcus multilocularis and risk of zoonotic infection of south Gansu farmers may be related ultimately to a process of deforestation driven by agriculture. This in turn probably results in creation of optimal peri-domestic habitats for rodents that serve as intermediate host species (such as M. limnophilus) and subsequent development of a peri-domestic cycle involving dogs.

Adult↗