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Forty-three patients with classical multiple myeloma were studied to assess the prevalence and characteristics of amyloid arthropathy using clinical, radiological, and histological methods. Two patients were found to have amyloid arthropathy, and a third case is described in detail. Complement and cryoprecipitate analysis of the synovial fluid, and electronmicroscopy of the synovium, synovial debris and cartilage were undertaken in an attempt to shed further light onto the pathogenesis of what has hitherto been regarded as a rare complication of multiple myeloma. Complement components were not depressed and no evidence of specific light chain containing immune complexes was found in synovial fluid cryoprecipitates. Histochemical and electron microscopic localization of amyloid in perichondrocytic lacunae as well as in synovial fluid debris, synovium and the articular cartilage surface suggest the possibility that chondrocytes and synovial macrophages may share a role in processing immunoglobulin components as a prelude to the formation of amyloid fibrils. Amyloid arthropathy occurs in about 5 per cent of patients with multiple myeloma. The clinical picture can resemble rheumatoid arthritis with median nerve compression in the carpal tunnel and symmetrical arthritis of the wrists and small joints of the hands. Diagnosis can be established by examination of Congo red stained synovial fluid sediments under polarized light even in the absence of other clinical features of amyloidosis and when rectal biopsy is negative.

Intermittent inescapable footshock (IIFS) treatment, administered to 3-month-old male rats, resulted in analgesia as well as discrete immunological and endocrine changes. The splenic lymphocyte proliferative response to concanavalin A (ConA) and phytohemagglutinin (PHA) was decreased by 20% and 41%, respectively. The primary IgM plaque forming cell (PFC) response to sheep red blood cells (SRBC), however, was not altered by IIFS administered either immediately or 24 h after injection of SRBC. IIFS also produced a significant (20-fold) increase in plasma corticosterone (CORT) as compared to non-shocked controls. The shock-induced suppression of splenic lymphocyte mitogenic response to PHA was blocked by 10 mg/kg naltrexone (NTX) administered immediately before IIFS. NTX alone had no effect on this mitogen response. However, NTX significantly attenuated the shock-induced rise in CORT even though NTX alone significantly elevated CORT in the non-shocked controls. These data suggest that IIFS alters cellular immune response but not the primary IgM PFC response (a measure of humoral immune function) and that the immunomodulatory effects may involve both an opioid and a corticosteroid component with respect to alterations in the splenic lymphocyte mitogenic response to PHA.

Twenty-nine confirmed cases of Salmonella nima enterocolitis in Canada and four cases in the United States were traced to gold-foil wrapped chocolate coins from Belgium. Illness in Canadian cases occurred between September 1985 and October 1986 where the primary case in each of 24 affected families was a child ≤ 14 years of age. A product recall was issued on October 3, 1986 in Canada. Quantitative analysis of four composite samples of suspect chocolate by the most probable number (MPN) technique showed levels of 4.3 to 24.0 S. nima per 100 g product. These levels of contamination and consumption of approximately 25 g of chocolate by primary cases suggest that small numbers of S. nima precipitated clinical symptoms.

Individual housing of previously group-housed animals was found to result in time-dependent changes in mitogen-induced lymphocyte proliferation and plasma corticosterone concentrations. During the first week of isolation, both B and T lymphocyte responses were depressed. However, within 2 weeks at least a 2-fold enhancement was observed. The increased lymphocyte response was still present after 35 days of isolation. Within the first day of isolation and continuing for 2 weeks, plasma corticosterone levels were found to be significantly decreased in isolated animals compared to those of continuously housed animals. No significant differences in steroid levels were observed by 35 days. These data demonstrate that isolation is accompanied by a depressed adrenocortical activity and suggest that the immunosuppression associated with short-term exposure is mediated by factors other than corticosterone.

The development of a practical cytotoxic micro-assay for detection of enterotoxins in crude bacterial lysates of E. coli and other Gram-negative bacteria, is described. This quantitative assay is based on growth inhibition of mouse-fibroblasts, maintained in suspension or by inhibition of uptake of DNA precursors. Guidelines for performing the assay and evaluating the results by statistical considerations, are described. The choice of a relatively cheap medium and a suitable number of target cells to achieve cell doubling in 24 h is given. The concentrations of proteins in the crude lysates from strains of different origin, are not of equal potency; a predetermined but different protein concentration for strains from infants, adults or porcine origin, are recommended for detection of the toxins and for achieving reproducible results. Production of toxic proteins is enhanced by mitomycin C in toxigenic strains and not in non-toxigenic strains. Screening of a limited number of lysates from E. coli strains originating from infants and a comparison of the cytotoxicity of several known toxigenic and non-toxigenic strains from human adults and porcine origin, are presented.

Turtles have long been implicated as carriers of salmonella species, which can and do infect humans. This report reviews the British Columbia Provincial Laboratory's experience with turtle-associated salmonellosis from 1964 to 1985. The author identifies the salmonella serotypes that were most often associated with turtles during this period and discusses the impact that public-health measures may have had on human salmonellosis.

A study was designed to establish the reliability of assessing joint tenderness in rheumatoid arthritis. Reliability both within and between observers was measured and the 95% confidence intervals (CI) for a change in score calculated. Forty-two patients were assessed by two metrologists over a 14-week period using three subjects per week. Results showed close agreement within and between metrologists. The 95% CI for repeat measures by the same metrologist was +/- 8.5 and +/- 12 by a different metrologist. Taking a change of 5 in the score as clinically significant, the 95% CI for a clinically significant change would be +/- 14 with one observer and +/- 17 when a different observer repeated the assessment. It is recommended that other centres should establish their own CI for a change in scores when undertaking clinical trials.

A 26-year-old female developed a unilateral hypoglossal nerve palsy in association with tuberculosis of the first cervical vertebra. The extensive soft tissue and bony abnormalities were demonstrated only by computerized axial tomography. Involvement of the hypoglossal nerve within the skull by tuberculous granulation tissue was the most likely mechanism for the nerve palsy.

Triphenyl phosphate (TPP), a potential food contaminant, was fed to weanling Spartan Sprague-Dawley rats at dose levels of 0, 0.25, 0.5, 0.75, and 1.0% for 120 days. The immunotoxicity evaluation, planned as a minimum testing model in a subchronic study design as well as to provide information on TPP, was performed along with the routine testing of a separate group of animals. Traditional measures were made of growth and food consumption, total protein analysis, electrophoretic analyses of serum proteins, lymphoid organ weights in relation to growth, and histopathology, with expanded immunohistochemical evaluation of B- and T- lymphocyte regions in spleen, thymus, and lymph nodes, using immunoperoxidase staining. Assessment was made of the humoral response to a T-lymphocyte-dependent antigen, sheep red blood cells, and was begun at midterm of the feeding period for the primary response followed by secondary and tertiary booster immunizations at 3-week intervals. The kinetics of the responses were measured by hemolysin assay of relative antibody titers at days 3, 4, 5, and 6 postinjection. No significant effects on the responses were noted for either sex at any of the dose levels tested. The only effects noted were a decreased rate of growth at high levels of TPP and increases in the levels of alpha- and beta-globulins suggestive of increased hepatic activity.

The effects of isolation and water scheduling on mitogen induced lymphocyte proliferation were investigated. Isolated rats were animals which had been raised in group-housed conditions and then transferred to individual cages with ad lib access to water for a 1 or 2 week period. Water scheduled rats were maintained in group housing (5 rats per cage) with ad lib access to food but with access to water for a single 30 minute session each day. Responses of these groups were compared to those of animals which had been continuously group-housed with ad lib access to food and water. No differences in lymphocyte responses to phytohemagglutinin (PHA) were found 1 week after exposure to isolation. However, after 2 weeks, splenic and blood T lymphocytes from isolated animals demonstrated an increased proliferative response to suboptimum and maximum concentrations of PHA. Splenic B lymphocyte responses to lipopolysaccharide (LPS) from isolated animals were also increased by 2- to 3-fold compared to group-housed controls. Two weeks of exposure of animals to daily water scheduling similarly increased the splenic lymphocyte proliferation. This increased responsiveness to PHA was not accompanied by a significant change in the sensitivity of the lymphocytes to PHA, in the total number of white blood cells, or the proportion of splenic T or T helper lymphocytes. Our results show that the increase in lymphocyte proliferation is time-dependent, requires greater than 1 week of exposure to isolation and is due to factors other than changes in sensitivity to mitogen or T lymphocyte number.

Azathioprine has been shown to reduce the steroid requirements of patients with severe rheumatoid arthritis. Twenty-seven patients treated with azathioprine have now been followed up for 30 months. At the end of this period only 10 were still taking the drug. Maximum steroid reduction occurred within the first 12 months of treatment. Some steroid-sparing effect seemed to persist after the drug was stopped. There was no evidence that azathioprine prevented radiological deterioration. No deaths occurred and toxic effects always reversed on stopping the drug.