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Volume: 5
Issue: 08
Date: 04-Aug-97


Table of Contents:

I.    LYMENET: CID Publishes Special Lyme Supplement
II.   LYMENET: Fallon Seeks Patients for Pediatric Study
III.  LDRC: Nominations Sought for Distinguished Physician Award
IV.   J CLIN MICROBIOL: Molecular characterization of a
      35-kilodalton protein of Borrelia burgdorferi, an antigen
      of diagnostic importance in early Lyme disease
V.    PEDIATR NEUROL: Lyme neuroborreliosis masquerading as a
      brainstem tumor in a 15-year-old
VI.   RHEUMATOL INT: Intracellular persistence of Borrelia
      burgdorferi in human synovial cells
VII.  About The LymeNet Newsletter


Newsletter:

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*                         LymeNet Newsletter                          *
***********************************************************************


IDX#                Volume 5 / Number 08 / 04-AUG-97
IDX#                            INDEX
IDX#
IDX#  I.    LYMENET: CID Publishes Special Lyme Supplement
IDX#  II.   LYMENET: Fallon Seeks Patients for Pediatric Study
IDX#  III.  LDRC: Nominations Sought for Distinguished Physician Award
IDX#  IV.   J CLIN MICROBIOL: Molecular characterization of a
IDX#        35-kilodalton protein of Borrelia burgdorferi, an antigen
IDX#        of diagnostic importance in early Lyme disease
IDX#  V.    PEDIATR NEUROL: Lyme neuroborreliosis masquerading as a
IDX#        brainstem tumor in a 15-year-old
IDX#  VI.   RHEUMATOL INT: Intracellular persistence of Borrelia
IDX#        burgdorferi in human synovial cells
IDX#  VII.  About The LymeNet Newsletter
IDX#



I.    LYMENET: CID Publishes Special Lyme Supplement
----------------------------------------------------
Sender: Marc Gabriel <a229@lehigh.edu>
Date: July 30, 1997


The journal Clinical Infectious Diseases has published a supplemental
issue containing research presented at the Ninth Annual International
Conference of Lyme Borreliosis and Other Tick-borne Diseases.  The
works contained in this supplement cover a wide range of topics, from
microbiology to serology, treatment to chronic issues.


The LymeNet Newsletter recommends this publication for any physician
who would like a primer on the vast array of issues surrounding LD.
For a complete table of contents, please visit:


         http://www.journals.uchicago.edu/CID/v25s1toc.html

Ordering information can be found at:

          http://www.journals.uchicago.edu/CID/order1.html


=====*=====


II.   LYMENET: Fallon Seeks Patients for Pediatric Study
--------------------------------------------------------
Sender: Marc Gabriel <a229@lehigh.edu>
Date: July 25, 1997


Dr. Brian A. Fallon, a physician noted for his investigation into
the neuropsychiatric effects of LD, is currently recruiting
children and adolescents to participate in a study of the cognitive
effects of pediatric LD.  Many children with LD experience
difficulties at home and school.  If properly diagnosed, many of
these children could benefit from psychiatric assistance.


The children will receive a free neuropsychological evaluation
as part of the study.  To qualify, candidates must meet the
following criteria:


* Between the ages of 9 and 16
* Be symptomatic for at least 6 months, but no more than 3 years
* Have physician diagnosed EM rash or positive Western Blot result
* Have symptoms that developed clearly after the onset of disease
* Have difficulty remembering things or paying attention


For more information on the study, please contact Felice Tager at:
(212) 543-5487.



=====*=====


III.  LDRC: Nominations Sought for Distinguished Physician Award
----------------------------------------------------------------
Sender: Phyllis Mervine <fredm@pacific.net>


The Lyme Disease Resource Center (LDRC) is accepting nominations for
the 1997 Distinguished Physician Award, which recognizes a physician
for clinical excellence, leadership, compassion, and dedication to
the treatment of Lyme disease.  The nomination deadline is September 1.
The first Distinguished Physician Award recipient was Paul Emile
Lavoie, MD, who died of pancreatic cancer at the age of 60 on January
23, 1994.  


Dr. Lavoie was a specialist in rheumatology and internal medicine in
private practice in San Francisco since 1973.  He held several medical
teaching appointments, including Clinical Professor of Medicine at
UCSF.  An active board participant of national, state, and local
organizations, he was also a Founding Fellow of the American
Rheumatology Association.  In 1977, Dr. Lavoie diagnosed the first
two cases of Lyme disease in the far-western United States.  He
subsequently played a major role in both the treatment and research of
Lyme disease, often bridging the gap between the clinician and the
biomedical community.  He treated hundreds of patients with Lyme
disease, and contributed 25 published papers on aspects ranging from
laboratory diagnosis to clinical approaches.  Lecturing widely, he
participated in special Lyme disease conferences at both the National
Institutes of Health and the Centers for Disease Control and
Prevention.


Dr. Lavoie was presented with the Distinguished Physician Award at the
LDRC Lyme disease conference in Ukiah, California, in October, 1993.  
In the last lecture of his life he reinterated a familiar theme: Lyme
disease is a complex, multisystem illness which is often missed by the
physician and may be recognized in only its later stages, with serious
consequences for the patient.  Dr. Lavoie was an unequivocal proponent
of long-term oral antibiotic treatment.


The first Distinguished Physician Award was given to Dr. Lavoie by the
Lyme Disease Resource Center and the Lyme Disease Foundation jointly,
and has not been awarded since.


Please submit nominations (with rationale) to LDRC, PO Box 1891,
Sonoma, CA 95476 by September 1, 1997.  The presentation will be made
at the LDRC Conference on Emerging Tick-Borne Diseases in the Western
United States in Los Angeles on September 13.



=====*=====


IV.   J CLIN MICROBIOL: Molecular characterization of a 35-kilodalton
     protein of Borrelia burgdorferi, an antigen of diagnostic
     importance in early Lyme disease
---------------------------------------------------------------------
AUTHORS: Gilmore RD Jr, Kappel KJ, Johnson BJ
ORGANIZATION: National Center for Infectious Diseases, Centers for
             Disease Control and Prevention, Fort Collins, Colorado
             <rbg9@cidvbil.em.cdc.gov>
REFERENCE: J Clin Microbiol 1997 Jan;35(1):86-91
ABSTRACT:


Antibodies against a 35-kDa antigen of Borrelia burgdorferi are
detectable in the serum of about half of patients with early Lyme
disease.  The gene encoding this antigen was isolated from a genomic
library of B. burgdorferi B31 (low passage), and full-length
expression of the recombinant gene product was achieved in
Escherichia coli.  Antiserum raised against the recombinant protein
was reactive with a B. burgdorferi protein of the same molecular size
as the diagnostic 35-kDa antigen cited in an earlier study of criteria
for the sero-diagnosis of early Lyme disease.  Also, the recombinant
protein was reactive with serum from patients with early Lyme disease
who were seropositive for the 35-kDa antigen.  DNA sequence analysis
of the gene indicated an open reading frame of 909 bp encoding a
protein with a calculated molecular mass of 34.3 kDa. This gene did
not possess the usual initiation codon ATG but rather probably used a
TTG codon.  The deduced amino acid sequence of the N terminus
exhibited a motif similar to that for signal peptides of lipoproteins.

Southern blotting revealed a chromosomal location for this gene; and
it was specific for B. burgdorferi, B. afzellii, and B. garinii but
not for B. hermsii, B. coriaciae, or B. turicatae.



=====*=====


V.    PEDIATR NEUROL: Lyme neuroborreliosis masquerading as a
     brainstem tumor in a 15-year-old
-------------------------------------------------------------
AUTHORS: Curless RG, Schatz NJ, Bowen BC, Rodriguez Z, Ruiz A
ORGANIZATION: Department of Neurology, Bascom Palmer Eye
             Institute, University of Miami School of Medicine,
             Florida
REFERENCE: Pediatr Neurol 1996 Oct;15(3):258-60
ABSTRACT:


A 15-year-old boy had onset of unilateral facial weakness.  A few days
later, he experienced mild vertigo, double vision, and headache.
Examination confirmed a peripheral right seventh nerve weakness in
addition to an internuclear ophthalmoplegia.  The neurologic features
suggested a pontine glioma.  A T2-weighted MRI scan revealed
demyelinating lesions in the pons and in several areas of the
cerebrum, including the periventricular region.  Subsequent history
revealed that he had been diagnosed with Lyme arthritis 7 years
earlier while living in Connecticut.  The radiographic studies
favored a diagnosis of multiple sclerosis.  However, studies of
blood and cerebrospinal fluid established a diagnosis of Lyme
neuroborreliosis.



=====*=====


VI.   RHEUMATOL INT: Intracellular persistence of Borrelia burgdorferi
     in human synovial cells
----------------------------------------------------------------------
AUTHORS: Girschick HJ, Huppertz HI, Russmann H, Krenn V, Karch H
ORGANIZATION: Children's Hospital, University of Wurzburg, Germany
REFERENCE: Rheumatol Int 1996;16(3):125-32
ABSTRACT:


To investigate if Borrelia burgdorferi can persist in resident joint
cells, an infection model using cell cultures of human synovial cells
was established and compared to the interaction of Borrelia
burgdorferi and human macrophages.  Borrelia burgdorferi were found
attached to the cell surface or folded into the cell membrane of
synovial cells analysed by transmission electron and confocal laser
scanning microscopy.  In contrast to macrophages, morphologically
intact Borrelia burgdorferi were found in the cytosol of synovial
cells without engulfment by cell membrane folds or phagosomes.
Borrelia burgdorferi were isolated from parallel cultures.  Treatment
with ceftriaxone eradicated extracellular Borrelia burgdorferi, but
spirochetes were reisolated after lysis of the synovial cells.
Borrelia burgdorferi persisted inside synovial cells for at least 8
weeks.  These data suggested that Borrelia burgdorferi might be able
to persist within resident joint cells in vivo.



=====*=====


VII.  ABOUT THE LYMENET NEWSLETTER
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         The Lyme Disease Network of New Jersey
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