Publications

not everything that glitters is lyme disease.		1992	1524093
the western fence lizard sceloporus occidentalis: evidence of field exposure to borrelia burgdorferi in relation to infestation by ixodes pacificus (acari: ixodidae).	the role of the western fence lizard sceloporus occidentalis in the enzootiology of the lyme disease spirochete borrelia burgdorferi was evaluated in the hopland and ukiah areas of mendocino county, california. in 1989, half of 74 lizards collected monthly from april to october at hopland were infested by the immature western black-legged tick ixodes pacificus at a mean intensity of 6.0 ticks per lizard. the prevalence of infestation of lizards by immature i. pacificus (36 of 73) at ukiah was si ...	1992	1524146
new lyme disease vaccine for dogs.		1992	1524271
delayed dissemination of lyme disease spirochetes from the site of deposition in the skin of mice.	to determine whether the agent of lyme disease disseminates in vertebrate hosts directly after deposition by an infecting tick, a 6-mm disk of skin was excised from the sites where nymphal ixodes dammini ticks infected by lyme disease spirochetes, borrelia burgdorferi, had fed. infection in each mouse was tested by examining xenodiagnostic ticks that had engorged on these mice 4 weeks later and by serologic testing. generalized infection was aborted when the site of inoculation was excised withi ...	1992	1527418
lymphocyte proliferation assay in lyme disease.		1992	1527433
lyme disease--a pediatric perspective.		1992	1527779
immunocytochemical identification of rochalimaea henselae in bacillary (epithelioid) angiomatosis, parenchymal bacillary peliosis, and persistent fever with bacteremia.	we report the immunocytochemical identification of rochalimaea henselae, a newly recognized fastidious, gram-negative, warthin-starry-positive organism, as the common pathogen in bacillary angiomatosis (ba), bacillary peliosis (bp) of the liver and spleen, and persistent fever with bacteremia in immunocompromised patients. immunogenic proteins of the r. henselae strain isolated from the blood of a febrile immunocompromised patient with bp of the liver were used to produce primary immune serum in ...	1992	1530106
neuroactive kynurenines in lyme borreliosis.	although neurologic dysfunction occurs frequently in patients with lyme borreliosis, it is rarely possible to demonstrate the causative organism within the neuraxis. this discordance could arise if neurologic symptoms were actually due to soluble neuromodulators produced in response to infection. since immune stimulation is associated with the production of quinolinic acid (quin), an excitotoxin and n-methyl-d-aspartate (nmda) agonist, we measured levels of csf and serum quin, and lymphokines. s ...	1992	1531156
nonspecific proliferative responses of murine lymphocytes to borrelia burgdorferi antigens.	proliferative responses of naive splenocytes to borrelia burgdorferi antigens from mice susceptible (c3h) and resistant (balb) to lyme borreliosis were investigated. b. burgdorferi spirochetes and recombinant outer surface proteins, ospa and ospb, were found to induce nonspecific proliferation of naive splenocytes from both strains of mice. cell purification studies localized nonspecific proliferation to the b cell-enriched fraction. b. burgdorferi, ospa, and ospb were found to induce igm and ig ...	1992	1531672
interleukin-1 (il-1) receptor blockade reduces endotoxin and borrelia burgdorferi-stimulated il-8 synthesis in human mononuclear cells.	interleukin-1 (il-1) is a potent stimulator of il-8 production by fibroblasts and monocytes. in the present study, we asked how much of endotoxin (lps)-induced il-8 production by human peripheral blood mononuclear cells was due to il-1 induced by lps. cells were stimulated with either il-1 beta, lps, or borrelia burgdorferi, and total il-8 was determined by a specific radioimmunoassay. the addition of saturating concentrations of il-1 receptor antagonist protein (irap) reduced the il-1 beta-, lp ...	1992	1532945
[lyme's disease, a possible cause of isolated acute myocarditis].	the frequency of cardiac lesion in patients with other signs of lyme disease has been estimated at 8 percent. the usual manifestation of myocardial involvement is a varying degree of atrioventricular block or more diffuse signs of myocarditis. autopsy or intramyocardial biopsy provides a histological diagnosis of myocarditis. microscopy shows a diffuse lympho-plasmocytic infiltrate with presence of macrophages in the myocardium, associated with a varying number of necrotic myocytes. structures r ...	1992	1535149
light chain distribution of anti-borrelia burgdorferi igg antibodies in lyme arthritis.	joint fluid (jf) and serum igg from eight lyme arthritis patients was investigated by isoelectric focusing, blotting to membranes of uncoated nitrocellulose (nc) as well as borrelia (b.) burgdorferi antigen-coated nc (immunoblot) and immunoezymatic staining for visualization of the igg isotype and characterization of the kappa/lambda light chain distribution. oligoclonal bands of total igg occurred in jf as well as in serum (3 cases) or in jf only (1 case); igg lambda components were present in ...	1992	1535989
diversity of tick species biting humans in an emerging area for lyme disease.	although most tick bites in humans in areas of the northeastern united states in which lyme disease is highly endemic are due to ixodes dammini, no study documents the frequency of i. dammini bites in low-prevalence or emerging areas for lyme disease. data on the proportion of tick bites in humans that are due to i. dammini in a region may have implications for public health policy and clinical management.	1992	1536337
complement-mediated in vitro bactericidal activity of monoclonal antibodies reactive with outer-surface-protein ospb of borrelia burgdorferi.	murine monoclonal antibodies (mabs) were obtained against the outer-surface-protein ospa and ospb and against the 41-kda flagellar antigen of borrelia burgdorferi. the specificity of mab was determined by the western blotting technique and the surface association of the antigens was inferred by immunofluorescence of living bacteria. in an in vitro assay in the presence of complement, two mabs reactive with the ospa were able to kill borreliae, whereas several mabs reactive with the ospa as well ...	1992	1537543
cultivation of borrelia burgdorferi from erythema migrans lesions and perilesional skin.	skin biopsy specimens from the peripheral aspect of erythema migrans lesions (site 1) and from clinically normal perilesional areas (site 2) were compared as sources of borrelia burgdorferi. this spirochete was isolated from the skin of 18 of 21 (86%) patients with untreated early lyme disease at one or both biopsy sites. site 1 specimens were superior to site 2 specimens for the isolation of b. burgdorferi. site 1 specimens from 18 (86%) patients were culture positive, and site 2 specimens from ...	1992	1537904
serodiagnosis of lyme borreliosis by western immunoblot: reactivity of various significant antibodies against borrelia burgdorferi.	the significance of various antibodies against borrelia burgdorferi was studied by western blot (immunoblot) by using 578 human serum samples. the proteins regularly detected by using samples from patients with lyme borreliosis were those with bands with molecular masses of 94, 83, 75, 66, 60, 55, 46, 41, 39, 34, 31, 29, 22, and 17 kda. the detectable frequencies of most of these proteins appeared to be significantly different between the sera from patients with lyme borreliosis and those from n ...	1992	1537905
capacity of european animals as reservoir hosts for the lyme disease spirochete.	the abundance of spirochete-infected ixodes ricinus ticks naturally derived from endemic rodents was compared to identify the reservoir hosts of the agent of lyme disease at a series of enzootic sites in central europe. black-striped mice appear to be the most important rodent host for the tick and infect more ticks with borrelia burgdorferi than do other mice and voles tested. although rodents infect about half of the ticks that feed on them, lizards infect none. these spirochete-incompetent ho ...	1992	1538153
cultivation of borrelia burgdorferi from the blood and a subcutaneous lesion of a patient with relapsing febrile nodular nonsuppurative panniculitis.		1992	1538171
evaluation of granulocytic ehrlichiosis in dogs of missouri, including serologic status to ehrlichia canis, ehrlichia equi and borrelia burgdorferi.	canine granulocytic ehrlichiosis was diagnosed in 37 dogs by finding ehrlichial morulae in 0.1 to 26.2% of their blood neutrophils and eosinophils. all 37 dogs had clinical signs of arthritis or muscular stiffness. titer to ehrlichia canis was determined in sera from 31 of the 37 dogs; 25 dogs had titer ranging from 1:20 to 1:5,120. in the other 6 dogs, titer to e canis was less than 1:10. the most common hematologic abnormality in these dogs, other than rickettsiemia, was thrombocytopenia. gran ...	1992	1539918
in vitro and in vivo induction of tumor necrosis factor alpha by borrelia burgdorferi.	tumor necrosis factor alpha (tnf-alpha) is an immunoregulatory cytokine with many biological activities including the mediation of inflammation. we examined sera and synovial fluids from patients seropositive for infection with borrelia burgdorferi using a radioimmunoassay specific for tnf-alpha. significant elevation of tnf-alpha was found in the sera and synovial fluids of patients examined, while controls showed no elevation. sera of mice infected with b. burgdorferi contained elevated levels ...	1992	1541526
long-term protection of mice from lyme disease by vaccination with ospa.	mice vaccinated with recombinant outer surface protein a (ospa) have been shown to be protected from infection with borrelia burgdorferi, the agent of lyme disease, when sacrificed 14 days after challenge with an intradermal inoculum of the spirochete. to determine whether infection was not merely delayed and that protection was long-lasting, we sacrificed vaccinated mice 60, 120, and 180 days after challenge; and to determine whether vaccinated mice retained their immune state over long periods ...	1992	1541551
interactions between extracellular borrelia burgdorferi proteins and non-borrelia-directed immunoglobulin m antibodies.	previous work showed that outer surface protein a (ospa) and ospb of borrelia burgdorferi may occur within an extracellular multiprotein complex, which was resolved by electrophoresis as an 83-kda major extracellular protein band. to characterize the 83-kda band, we sequenced the n terminus of the predominant peptide in the band and examined the interaction between the associated proteins. peptide sequence and amino acid composition comparisons showed identity with the heavy chain of immunoglobu ...	1992	1541558
diagnosing lyme disease.		1992	1543317
borrelia burgdorferi strain 25015: characterization of outer surface protein a and vaccination against infection.	mice vaccinated with outer surface protein a (ospa) from borrelia burgdorferi strain n40 are protected from challenge with an intradermal syringe inoculum of b. burgdorferi strains n40, b31, and cd16. vaccination experiments were done to determine if protection extended to strains 297 and 25015. we now show that ospa-n40 immunized mice are protected against challenge with strain 297, isolated from the cerebrospinal fluid of a patient with neuroborreliosis, but not against challenge with strain 2 ...	1992	1545130
population genetic analysis of borrelia burgdorferi isolates by multilocus enzyme electrophoresis.	fifty borellia burgdorferi strains isolated from humans and ticks in europe and the united states were analyzed by multilocus enzyme electrophoresis. eleven genetic loci were characterized on the basis of the electrophoretic mobilities of their products. ten loci were polymorphic. the average number of alleles per locus was 5.9, with a mean genetic diversity of 0.673 among electrophoretic types (ets). the strains were grouped into 35 ets constituting three main divisions (i, ii, and iii) separat ...	1992	1548090
[pigmented urticarial erythema with flaccid atrophy as expression of an unusual manifestation of lyme borreliosis].	unusual courses of infections with borrelia burgdorferi can make diagnosis problematic, but early and adequate therapy is mandatory to avoid further complications. in this paper a patient is presented who developed urticarial erythemas and hyperpigmentation with slack skin atrophy. positive serological findings and the regression of the skin eruptions under antibiotic therapy confirmed the diagnosis of an unusual manifestation of lyme borreliosis.	1992	1548134
relationship between development of antibodies to borrelia burgdorferi in dogs and the subsequent development of limb/joint borreliosis.	the relationship between antibody production and the subsequent development of limb/joint disorders of borreliosis was examined in dogs from south central connecticut. dogs without signs of illness, determined by physical examination, were selected from dogs being tested for dirofilaria immitis. an elisa was used to detect antibodies to borrelia burgdorferi in 234 apparently healthy dogs during 1988. these dogs were monitored for 20 months after initial analyses to determine the prevalence of li ...	1992	1548169
clinically silent infections in patients with oligoarthritis: results of a prospective study.	oligoarticular synovitis of undetermined origin can closely resemble an incomplete form of reactive arthritis/reiter's syndrome. eighty three patients with oligoarthritis of undetermined origin were studied prospectively to identify asymptomatic infections potentially triggering the inflammatory response in the synovial fluid. at the time of initial evaluation, 57 (69%) of the patients with oligoarthritis and 4/20 (20%) of the control subjects were carriers of clinically silent infections. evide ...	1992	1550413
lyme disease in children: diagnosis, treatment, and prevention.	lyme disease is a multisystem disorder that is caused by infection with borrelia burgdorferi. in endemic areas, its occurrence is extremely common among children. the early diagnosis and treatment of lyme disease may prevent the development of serious cardiac, rheumatological, and neurological sequelae. for this reason, a full understanding of the clinical manifestations, laboratory evaluation, and antibiotic therapy of lyme disease is of vital importance.	1992	1550714
dna analysis of borrelia burgdorferi nch-1, the first northcentral u.s. human lyme disease isolate.	the dna of the first northcentral united states human lyme disease isolate, borrellia burgdorferi nch-1, was characterized and compared with the dnas of nine other b. burgdorferi isolates. strain nch-1 was isolated in august 1989 from a human skin biopsy specimen. dna was analyzed by pulsed-field gel electrophoresis and restriction endonuclease analysis. contour-clamped homogeneous electric field pulsed-field gel electrophoresis of in situ-lysed cells was performed to compare the plasmid profile ...	1992	1551988
analysis of leptospira spp., leptonema illini, and rickettsia rickettsii for the 39-kilodalton antigen (p39) of borrelia burgdorferi.	five serovars of leptospira interrogans, leptospira biflexa, leptonema illini, and rickettsia rickettsii were examined and found not to contain the 39-kda antigen (p39) of borrelia burgdorferi, the lyme disease spirochete. the specificity of this antigen and its reactivity with human lyme disease sera should exclude the possibility of false-positive serum samples from patients having had either leptospirosis or rocky mountain spotted fever, as well as tick-borne relapsing fever and syphilis, as ...	1992	1551994
minocycline in lyme disease.		1992	1552067
polymerase chain reaction confirmation of borrelia burgdorferi in benign lymphocytic infiltrate of dermis.		1992	1552070
distribution, density, and lyme disease spirochete infection in ixodes dammini (acari: ixodidae) on white-tailed deer in maryland.	a statewide survey of ticks parasitizing white-tailed deer was carried out in maryland during november 1989 to assess the status of the deer tick, ixodes dammini spielman, clifford, piesman & corwin, the major vector of lyme disease in the northeastern united states. ticks were collected from deer carcasses brought in by hunters at 23 check stations (one per county). a total of 3,437 i. dammini were collected from 538 of 1,281 deer (42%), together with 2,013 dermacentor albipictus (packard) and ...	1992	1552529
[the characterization of a spanish strain of borrelia burgdorferi].	the characteristics of a spanish strain of borrelia burgdorferi, the spirochete which causes lyme's disease, and which, up to the present, has not been isolated in spain, are described.	1992	1552756
[lyme disease in spain].		1992	1552758
[peripheral facial paresis as a symptom of borrelia burgdorferi infection].	infection with the tick-borne borrelia burgdorferi can lead to a variety of neurologic symptoms, the most frequent being a radicular pain syndrome due to meningitis. general symptoms such as asthenia or headache are also frequent, however, and serious neurologic complications such as dementia or spastic paresis may occur. at an early stage, borrelia infections can be easily treated with antibiotics, which makes it important to recognize the symptoms and make the correct diagnosis. a common featu ...	1992	1553645
structural analysis of an outer surface protein from the lyme disease spirochete, borrelia burgdorferi, using circular dichroism and fluorescence spectroscopy.	the etiological agent of lyme disease is the tick-borne spirochete, borrelia burgdorferi. a major antigen of b. burgdorferi is a 31 kda lipoprotein called outer surface protein a (ospa). recently, a truncated form of ospa (lacking 17 amino acids at the n-terminus) was cloned, expressed and purified in large quantities (dunn, j.j., lade, b.a. and barbour, a.g. (1990) protein expression and purification 1, 159-168). the truncated protein (ospa-257) is water-soluble, retains the ability to bind ant ...	1992	1554741
purification and characterization of a tryptic peptide of borrelia burgdorferi flagellin, which reduces cross-reactivity in immunoblots and elisa.	in man the early immune response in lyme disease is primarily directed against the endoflagellin antigen. isolated flagellar protein of borrelia burgdorferi suggests itself as a suitable test antigen. however, cross-reactivity between flagellins of b. burgdorferi, escherichia coli, bacillus subtilis, proteus mirabilis and salmonella typhimurium was demonstrated by immunoblotting and elisa with polyclonal rabbit-hyperimmune-sera. tryptic cleavage of recombinant b. burgdorferi 41 kda flagellin, ex ...	1992	1556546
adherence and entry of borrelia burgdorferi in vero cells.	adherence to and entry of the parasite into the host is one of the essential elements of microbial pathogenicity. we investigated the adherence to and entry into primate kidney epithelial (vero) cells of borrelia burgdorferi by radiolabelling techniques, immunofluorescence and electronmicroscopy. the attachment to and subsequent entry of both untreated and heat (50 degrees c)-treated b. burgdorferi into vero cells occurred at cell-surface sites associated with aggregated coated pits. in contrast ...	1992	1560445
molecular analysis and expression of a borrelia burgdorferi gene encoding a 22 kda protein (pc) in escherichia coli.	we describe the cloning and expression of the pc gene which encodes a major immunodominant protein of borrelia burgdorferi, the causative agent of lyme borreliosis. the pc protein was purified from lysates of b. burgdorferi strain pko. after tryptic digestion of the pc protein the resulting oligopeptides were applied to a gas-phase sequenator. thus partial amino acid sequences were obtained. the deduced oligonucleotides were used as hybridization probes. after southern blotting a reactive band i ...	1992	1560779
heterogeneity of outer membrane proteins in borrelia burgdorferi: comparison of osp operons of three isolates of different geographic origins.	biochemical and immunochemical studies of the outer membrane proteins of borrelia burgdorferi have shown that the ospa and ospb proteins from strains of different geographic origins may differ considerably in their reactivities with monoclonal antibodies and in their apparent molecular weights. to further characterize this variation in osp proteins between strains, the osp operons and deduced translation products from two strains, one from sweden (acai) and one from eastern russia (ip90), were s ...	1992	1563773
nucleotide sequence of the ospab operon of a borrelia burgdorferi strain expressing ospa but not ospb.	the nucleotide sequence of a 1.6-kb clone containing the gene for outer surface protein a (ospa) of a german strain (go2) of borrelia burgdorferi was determined. the deduced amino acid sequence showed a homology of 82% to the ospa molecules from three other b. burgdorferi strains. the best-conserved region was recognized at the 36-amino-terminal amino acids of ospa. ospb could not be identified in the strain investigated, probably because the nucleotide sequence of the ospab operon prevented exp ...	1992	1563775
an initial investigation of the status of borrellia burgodorferi and its suspected primary vector, ixodes scapularis, in south carolina.	based on a survey of hunter-harvested deer, the suspected primary vector of lyme disease in the southeast, i. scapularis, is most prevalent in sandhill and coastal plain counties of south carolina. none of 271 i. scapularis examined were found to be infected with the lyme disease spirochete. however, many more specimens of i. scapularis, a. americanum, and other tick species must be examined before an accurate estimate of the probability of acquiring lyme disease in south carolina can be made.	1992	1564909
lyme disease in dogs in spain.		1992	1566536
lyme disease and radiologic findings in lyme arthritis.	lyme disease typically begins in the spring or summer months, with a pathognomonic skin lesion and associated flulike or meningitislike symptoms. if the patient is not treated during this early stage, cardiac, neurologic, or musculoskeletal manifestations may occur weeks to months later. although the clinical picture of lyme disease is extremely variable, the diagnosis can be made in most cases by recognizing the typical patterns of organ involvement and associated immunologic abnormalities.	1992	1566669
tandem repeat of the 23s and 5s ribosomal rna genes in borrelia burgdorferi, the etiological agent of lyme disease.	the dna fragments containing the rrl and rrf genes were subcloned from a embl3 recombinant phage of borrelia burgdorferi strain b31 into puc18 and were characterized by restriction analysis and southern hybridization. a fine restriction map of the fragments was constructed and the organization of the genes was determined. the genomic hybridization using the gene probes from b. burgdorferi showed that there are two sets of rrl/rrf genes in that genome. the results also revealed the important fact ...	1992	1567408
molecular diagnosis of borrelia burgdorferi infection (lyme disease).	in spite of significant advances in immunologically based testing, accurate diagnosis of lyme borreliosis remains problematic. to address this issue, a dna amplification-based diagnostic test was developed utilizing the polymerase chain reaction (pcr) and oligonucleotide primers specific for the ospa and ospb genes of borrelia burgdorferi. in this approach, a relatively large dna fragment is amplified with an outer set of primers, and a "nested" internal sequence of the pcr product subsequently ...	1992	1567553
detection of plasma tumor necrosis factor, interleukins 6, and 8 during the jarisch-herxheimer reaction of relapsing fever.	the jarisch-herxheimer reaction (j-hr) is a clinical syndrome occurring soon after the first adequate dose of an antimicrobial drug to treat infectious diseases such as lyme disease, syphilis, and relapsing fever. previous attempts to identify factors mediating this reaction, that may cause death, have been unsuccessful. we conducted a prospective trial in addis ababa, ethiopia on 17 patients treated with penicillin for proven louse-borne relapsing fever due to borrelia recurrentis to evaluate t ...	1992	1569394
untreated neuroborreliosis: bannwarth's syndrome evolving into acute schizophrenia-like psychosis. a case report.	in general, meningopolyradiculitis (bannwarth's syndrome, stage 2 of neuroborreliosis) follows a predictable monophasic self-limiting course. in contrast, we report the case of a patient with an untreated meningopolyradiculitis which evolved into acute schizophrenia-like psychosis due to persistent infection with borrelia burgdorferi. the psychosis resolved within 1 week of treatment with ceftriaxone. this case shows that the usually benign monophasic meningopolyradiculitis may progress to sever ...	1992	1573415
ultrasonography for the diagnosis of lyme disease in cases of acute facial paralysis.	ultrasonography of the parotid gland was introduced in 1989 as part of the diagnostic protocol of every patient treated in our clinics with acute facial paralysis. ten of 50 patients so tested were found to have unilateral nonpalpable enlarged lymph nodes in the caudal portion of the parotid gland around the stylomastoid foramen. all 10 patients were eventually diagnosed as having lyme disease. it is suggested that in patients with acute facial paralysis, ultrasonography is an inexpensive tool t ...	1992	1573949
deer, ticks, and lyme disease.		1992	1574226
incidence and prevalence of lyme disease in a suburban westchester county community.	this study was designed to determine the incidence and prevalence of lyme disease in a section of chappaqua, ny, a residential community in which lyme disease is epidemic, and to identify risk factors for this disease. on the basis of clinical history and baseline serologic testing, the overall prevalence of lyme disease for 114 persons entering the study was 8.8%. the incidence during the 5-month study period of may through september 1989 was 2.6%; all three incident cases had erythema migrans ...	1992	1574232
lyme disease case studies.	lyme disease is the commonest tick-borne disease in the united states. since the mill creek clinic opened in march 1991, we have diagnosed two cases of the total five cases of lyme disease reported in west virginia.	1992	1574875
diagnosing lyme disease.	the incidence of lyme disease is increasing, and the disease is spreading geographically. prompt diagnosis requires recognition of characteristic signs and symptoms of infection with the spirochete borrelia burgdorferi. in more than half of cases, erythema migrans is the earliest sign of lyme disease. although less frequently seen than erythema migrans, peripheral neuropathy of the seventh cranial nerve is another important sign. tests for lyme disease await refinement, but laboratory evaluation ...	1992	1575110
[oligosymptomatic lyme disease. diagnosis in primary care].		1992	1576196
[nodular panniculitis: a manifestation of lyme borreliosis?].	infection with borrelia burgdorferi can induce various skin manifestations. the type of skin manifestation and the histopathological picture depend on the stage of infection and vary from local inflammatory infiltrates to chronic atrophic skin disease. involvement of subcutaneous tissue has been observed only very rarely. we report on two patients suffering from nodular panniculitis (pfeifer-weber-christian) and present evidence that the disease was caused by borrelia burgdorferi. in one of the ...	1992	1577601
[comment on the contribution by c. garbe: borreliosis of the skin--progress of knowledge since the discovery of lyme disease].		1992	1577606
complications of lyme borreliosis.	lyme borreliosis is the multisystem infectious disease caused by the spirochete borrelia burgdorferi. complications of this infection can involve many organ systems, especially the skin, joints, nervous system, and heart. these manifestations may be acute, or evolve slowly over months or years. diagnosis is not always straightforward, and is currently hampered by lack of a specific serologic assay. this review discusses the syndromes associated with lyme borreliosis and addresses issues of diagn ...	1992	1580609
foot and ankle pain resulting from rheumatic conditions.	pain in the foot and ankle is most frequently secondary to static and degenerative changes, eg, corns, hammer toes, bunions, anterior metatarsalgia, and heel pain. a second common group consists of rheumatologic disorders that encompass immune and hereditary factors. this group includes rheumatoid arthritis, the often underdiagnosed seronegative spondyloarthropathies, and, less commonly, crystalline deposit disorders and diffuse connective tissue diseases. both the physician and the public need ...	1992	1581152
[borrelia burgdorferi may be the causal agent of sarcoidosis].	serum antibody to borrelia burgdorferi was measured in 33 patients with sarcoidosis who were confirmed clinically and pathologically. the results showed that 81.8% of the patients were positive. in addition, a strain of borrelia burgdorferi was isolated from a patient's blood. fourteen patients received ceftriaxone 2 g per day and/or penicillin 12 million per day and a patient received lincomycin 1.2 g per day. the antibody titer of the patients turned to normal level, their sace turned to norma ...	1992	1582344
false positive reactions occurring with the captia syphilis-g eia, in sera from patients with lyme disease.		1992	1582661
seroepidemiological studies of borrelia burgdorferi infection in sheep in norway.	an enzyme-linked immunosorbent assay for antibodies to borrelia burgdorferi in sheep was established. the assay was used in a seroepidemiological survey in which serum samples from 327 norwegian rams were screened for antibodies to b. burgdorferi. these rams were randomly chosen, clinically healthy animals from all parts of norway. they came both from areas where ixodes ricinus is common and from areas where the tick has not been found. the age of the animals varied from 0.5 to 7.5 years. sera f ...	1992	1583130
difficulties with lyme serology.	lyme disease is a multisystem infection characterized by dermatologic, neurologic, and arthritic findings. like syphilis, lyme borreliosis may imitate several other infectious and non-infectious diseases. diagnosis is dependent on a reliable history (if available), clinical findings, and blood serology findings. a major problem has been seronegativity in persons possessing the disease (false negatives). at present, seronegativity in persons strongly suspected of having lyme disease does not nece ...	1992	1583267
serologic diagnosis of lyme disease using recombinant outer surface proteins a and b and flagellin.	recombinant (r) outer surface proteins (osp) a and b, flagellin, and an immunogenic region of flagellin (41-g) from borrelia burgdorferi were evaluated using immunoblot and elisa for usefulness as substrates in diagnostic testing for lyme disease. antibodies to rospa, rospb, and r-flagellin were detected by immunoblot and elisa using the recombinant proteins. patients with late disease responded to rospa, rospb, and r-flagellin, or only to r-flagellin, whereas patients with early disease showed ...	1992	1583333
prevalence of antibody to borrelia burgdorferi by indirect fluorescent antibody assay, elisa, and western immunoblot in healthy adults in wisconsin and arizona.	the prevalence of antibody to borrelia burgdorferi in healthy adults from wisconsin and arizona was determined by indirect fluorescent antibody assay (ifa), elisa, and western immunoblotting. a total of 301 sera from adult volunteer blood donors were collected from three areas of wisconsin and compared with 49 consecutive anonymous adult volunteer donor sera from tucson, arizona, an area without reported lyme borreliosis. regional differences in seropositivity were found for western immunoblotti ...	1992	1583334
lyme neuroborreliosis manifesting as an intracranial mass lesion.	lyme neuroborreliosis is one of the chronic manifestations of lyme disease and is caused by the neurotropic spirochete, borrelia burgdorferi. two of the three stages of lyme disease potentially involve the central nervous system: a second stage that may manifest as meningitis, cranial neuritis, or radiculoneuritis; and a third stage, or chronic neuroborreliosis, with parenchymal involvement. the tertiary stage may mimic many conditions, including multiple sclerosis, polyneuropathy, viral encepha ...	1992	1584393
[lyme borreliosis in an endemic region in europe. prevalence of antibodies and clinical spectrum].	a representative sample of the population of two villages located in an area of north baden where borreliosis is endemic was studied to ascertain the prevalence of antibodies against borrelia burgdorferi and of clinical abnormalities. the aim of the study was to determine what clinical symptoms and signs were correlated with positive antibody status. out of the 2928 inhabitants 1228 were investigated, and 207 of these (16.9%) were seropositive. certain clinical abnormalities showed highly signif ...	1992	1587208
is it lyme disease? how to interpret results of laboratory testing.	although laboratory testing is likely to have a greater role in diagnosis and monitoring of treatment of lyme disease in the future, at present physicians must rely on a combination of history taking, clinical manifestations, and laboratory results. unwarranted antibiotic therapy is to be avoided. asymptomatic persons with positive serologic results who live in an endemic area present a challenge, and borderline serologic results in patients with manifestations of late lyme disease are also trou ...	1992	1589367
antibiotic treatment of lyme disease. current recommendations by stage and extent of infection.	much has been learned about lyme disease over the past several years, but much remains to be learned. careful clinical observation has led to elucidation of the natural history of this disease, and further clinical observations are needed to unravel the remaining areas of uncertainty. it is by no means clear that all the symptoms attributed to lyme disease today actually represent true manifestations of borrelia burgdorferi infection or that patients with well-documented lyme disease whose sympt ...	1992	1589368
special concerns in lyme disease. seropositivity with vague symptoms and development of fibrositis.	fear of lyme disease may be as powerful as the disease itself. patients may insist on being tested for infection although little evidence of it exists, and a positive result in the face of vague symptoms can add to the problem. physicians should explain to these patients the differences in "background" seropositivity in various geographic locations and the drawbacks of instituting unnecessary treatment. fibrositis may evolve over time after lyme disease infection. many factors may trigger this d ...	1992	1589369
physical map of the linear chromosome of the bacterium borrelia burgdorferi 212, a causative agent of lyme disease, and localization of rrna genes.	the spirochete borrelia burgdorferi, which causes lyme disease, and other members of the borrelia genus are unique among characterized bacteria in having a linear chromosome. a restriction map of the chromosome of b. burgdorferi 212 was constructed by making extensive use of digestions in agarose blocks of restriction endonuclease fragments or chromosomal dna that had been purified by pulsed-field gel electrophoresis. a total of 47 digestion sites for the enzymes sgrai, sacii, mlui, bsshii, eagi ...	1992	1592827
identification of a third genomic group of borrelia burgdorferi through signature nucleotide analysis and 16s rrna sequence determination.	as part of a continuing effort to assess genetic variation among isolates of borrelia burgdorferi we have determined the 16s rrna signature nucleotide makeup of two tick isolates from the ussr. signature nucleotides were identified via reverse transcriptase primer extension sequencing of select regions of the 16s rrna molecule. in addition, the near complete 16s rrna sequence of one of the isolates, r-ip3, was determined and utilized in a phylogenetic assessment. the sequence was aligned with th ...	1992	1593264
is there any evidence for an association between ankylosing spondylitis and borrelia burgdorferi infection?	the suggested relationship between borrelia burgdorferi and seronegative spondyloarthropathies has been studied in 125 patients with ankylosing spondylitis (as). igg antibodies to borrelia burgdorferi were present in 11 of 125 patients (8.8%) and in 25 of 125 controls (20%). no patient had clinical lyme borreliosis. hla-b27 status was known for 82 patients with as. there was no difference between b27+ and b27 patients. this study provides no evidence that borrelia burgdorferi is associated with ...	1992	1593580
frequency and specificity of antibodies that crossreact with borrelia burgdorferi antigens.	the frequency and specificity of antibodies that bind antigens of borrelia burgdorferi in sera from 200 individuals with no evidence of past or current lyme disease was determined. sera were tested for both igg and igm antibodies to b. burgdorferi by western blotting. the non-lyme serum group included specimens from healthy adults and children in addition to specimens from patients with viral infection and rheumatic diseases. crossreactive igg antibodies occurred more frequently than igm antibod ...	1992	1593581
babesiosis: an underdiagnosed disease of children.	babesiosis is a malaria-like illness caused by the intraerythrocytic parasite babesia microti and is transmitted by the same tick that transmits borrelia burgdorferi, the causative agent of lyme disease. babesiosis is well recognized in adult residents of southern new england and new york but has been described in only five children. to determine whether children are infected with b microti less often than are adults, a prospective serosurvey was carried out on block island, ri, where babesiosis ...	1992	1594345
[epidemiological aspects of neurological complications of lyme borreliosis in switzerland. a case-control study].	to determine the individual relative risk to neurologically affected patients of infection with borrelia burgdorferi, within the framework of a multicenter case control study encompassing the four neurological departments of the universities of basel, bern, zurich and lausanne, 378 patients and 1134 healthy blood donors serving as controls underwent analysis for antibodies against borrelia burgdorferi by elisa. the seroprevalence were estimated for a cut-off point of 2 standard deviations from t ...	1992	1594902
[mono-arthritis of uncertain etiology--a follow-up study].	78 patients in whom the cause of a monoarticular arthritis remained unclear after an initial workup were contacted for a follow-up interview (and an additional clinical examination in 64 cases) after 6 to 11 years (mean 8 years). the mean age at the onset of symptoms was 39 years, with 51% of the patients presenting in the range between 20 and 40 years. there was a slight male preponderance (56%). large joints, mainly the knee, and less often the wrist, ankle or hip, were affected in 79%. finger ...	1992	1594908
suspected lyme borreliosis in sheep.	two cases of suspected lyme borreliosis in lambs are described. the clinical signs observed resemble those described for lyme borreliosis in dogs and horses. the lambs were approximately six months old and came from two different flocks in a district heavily infested with ixodes ricinus ticks. the lambs had pronounced lameness in one leg, generally bad condition and poor appetite. they had high serum levels of igg antibodies to borrelia burgdorferi when tested in an elisa. the other lambs in the ...	1992	1595160
prevention of lyme disease.	lyme disease and the use of tick repellents and physical protective measures to prevent the disease are discussed. lyme disease is a multiple-organ-system, immune-mediated inflammatory disorder transmitted by the bites of ixodid ticks infected with borrelia burgdorferi. an individual is at greatest risk for infection when a tick has been attached to the skin for more than 24 hours. lyme disease occurs in three stages and may affect the skin, nervous system, cardiac system, and joints. antimicrob ...	1992	1595748
lyme disease?		1992	1596214
acute, posterior, multifocal, placoid, pigment epitheliopathy and lyme disease.		1992	1596215
cross-reactive proteins of borrelia burgdorferi.	the specificity of serological tests for lyme borreliosis is impaired by cross-reacting antibodies. in order to select antigens for more specific tests, specific and cross-reactive proteins of borrelia burgdorferi must be identified. therefore, to analyze cross reactions of borrelia burgdorferi with other bacteria, rabbit immune sera against heterologous bacteria (borrelia hermsii, treponema pallidum, treponema phagedenis, leptospira interrogans (serogroup grippotyphosa), neisseria meningitidis, ...	1992	1597198
seroprevalence of lyme disease in gray wolves from minnesota and wisconsin.	to determine the seroprevalence of lyme disease in gray wolves (canis lupus) from various counties of minnesota and wisconsin (usa), 589 serum samples were collected from 528 wolves from 1972 to 1989. an indirect fluorescent antibody (ifa) test was used to detect the presence of antibodies against borrelia burgdorferi. titers of greater than or equal to 1:100 were considered positive. results were confirmed by testing a few selected sera by western blotting. of the 589 sera tested, 15 (3%) had i ...	1992	1602567
isolation of borrelia burgdorferi from peromyscus leucopus in oklahoma.	borrelia burgdorferi was isolated from a field-caught peromyscus leucopus from central oklahoma (usa). the strain was identified as b. burgdorferi by reaction with monoclonal antibody h5332 specific for the outer surface protein ospa of b. burgdorferi. this represents the first isolation of b. burgdorferi from a wild mouse outside of the normal range of the known vectors ixodes dammini and i. pacificus.	1992	1602581
isolation of borrelia burgdorferi from a lyme seronegative patient in northern italy: expression of ospb immunodominant proteins on the isolated strain.	this paper describes the antigenic characteristics of a strain of borrelia burgdorferi isolated from a patient seronegative for lyme borreliosis, in the early stage of the illness. the strain was not recognized by a late serum sample from the patient; the isolate reacted in immunoblotting with some of the monoclonal antibodies directed against the immunodominant antigens of borrelia burgdorferi. in addition to the ospa antigen this strain carries also the epitopes of ospb proteins, unlike the ma ...	1992	1602993
differential cleavage of surface proteins of borrelia burgdorferi by proteases.	the differential cleavage of surface proteins of borrelia burgdorferi irs strains by several proteases was examined. proteinase k, trypsin, chymotrypsin and thermolysin all cleaved the outer surface protein b (ospb) to undetectable levels by coomassie brilliant blue staining, whereas some residual protein was detected by immunoblotting with polyclonal and monoclonal antibodies. not even antigenic fragments were detectable by immunoblotting with 1a8 monoclonal antibody reactive with ospb. less ef ...	1992	1602994
furor at lyme disease conference.		1992	1604309
lyme disease in california: a novel enzootic transmission cycle of borrelia burgdorferi.	knowledge of zoonotic transmission cycles is essential for the development of effective strategies for disease prevention. the enzootiology of lyme disease in california differs fundamentally from that reported from the eastern united states. woodrats, not mice, serve as reservoir hosts, and ixodes neotomae, a nonhuman-biting tick, maintains the agent of lyme disease, borrelia burgdorferi, in enzootic cycles. the western black-legged tick, ixodes pacificus, is the primary vector to humans, but i ...	1992	1604318
[prevalence of borrelia burgdorferi infection in an area of barcelona].		1992	1606233
the clinical and epidemiological profile of lyme neuroborreliosis in denmark 1985-1990. a prospective study of 187 patients with borrelia burgdorferi specific intrathecal antibody production.	this prospective study reports the clinical and epidemiological features of 187 consecutive patients with neuroborreliosis recognized in denmark over the 6-yr period, 1985-1990. only patients with intrathecal borrelia burgdorferi specific antibody synthesis were included. in 1990 regional incidences varied between 5.7 and 24.1 per million. ninety-four percent of the patients had early (second stage) neuroborreliosis. the most common manifestation was a painful lymphocytic meningoradiculitis (ban ...	1992	1606475
elimination of borrelia burgdorferi from vector ticks feeding on ospa-immunized mice.	although recombinant outer surface protein a (ospa) of borrelia burgdorferi protects mice against injected lyme disease spirochetes, the mode of protection has not yet been explored. indeed, the efficacy of vaccine-induced immunity against a realistic vector-mediated challenge remains unexplored. accordingly, we determined whether this immunogen protects mice against spirochetes delivered by nymphal ixodes dammini ticks. following challenge by tick bite, no spirochetes could be cultured from imm ...	1992	1608951
biting back at lyme disease.		1992	1609273
[positive anti-borrelia antibodies in patients with clinical manifestations compatible with neuroborreliosis].	the clinical features of 19 patients with neurological manifestations unexplained by another disease and positive serology for borrelia burgdorferi were studied. ecm was present in only 11% of the cases and 32% referred tick bite. the characteristic features for suspicion of nb according to our series was the presence of polyneuritis in 84% of the cases specially in the form of multiple mononeuritis and involvement of the facial nerve (79%) leading to even greater suspicion with the association ...	1992	1610600
characterization of borrelia burgdorferi glycoconjugates and surface carbohydrates.	borrelia burgdorferi glycoconjugates with different oligosaccharide structures were characterized by a blotting technique with peroxidase-labelled lectins. the localization of surface carbohydrates was studied using electron microscopy with lectin-gold complexes. a high-mannose glycan structure was detected in 83 kda glycoprotein (major extracellular protein); at least four carbohydrates (glucose or mannose, galactose, n-acetylgalactosamine and n-acetylglucosamine) were present in other borrelia ...	1992	1611204
analysis and expression of the borrelia burgdorferi p/gau fla gene: identification of heterogeneity with the b31 strain.	the flagellin gene from the p/gau strain of borrelia burgdorferi was cloned and sequenced. the translated p/gau flagellin protein differed from the flagellin of the b31 strain at 13 of 336 amino acids. this includes seven differences between amino acids 190-234, an immunodominant and specific region for b. burgdorferi. the entire flagellin molecule, as well as peptides of the internal portion of the protein which is more specific for b. burgdorferi, has been expressed in escherichia coli using a ...	1992	1612419
immunoglobulin g2 confers protection against borrelia burgdorferi infection in lsh hamsters.	we showed that immune serum and its immunoglobulin fractions, specifically immunoglobulin g2 (igg2), could confer complete protection to irradiated hamsters challenged with the lyme disease spirochete. immune serum and its immunoglobulin fractions also killed borrelia burgdorferi in vitro. depletion of complement in vivo abrogated the ability of igg2 to confer complete protection against b. burgdorferi. furthermore, the majority of antibody reactivity directed against b. burgdorferi was found in ...	1992	1612738
lyme disease.	lyme disease, a multisystem disorder, has now been reported to the centers for disease control from 43 states of the united states. the disease is a tick-transmitted infectious disorder caused by the spirochete bacterium borrelia burgdorferi. lyme disease typically begins with the symptoms of flu associated with a characteristic skin rash, erythema chronicum migrans. the diagnosis of lyme disease is best made by clinical examination and epidemiologic history, with serologic studies supporting th ...	1992	1612941
chronic lyme disease arthritis: review of the literature and report of a case of wrist arthritis.	a case of lyme arthritis with advanced degenerative changes localized to the midcarpal joint was treated with a limited wrist arthrodesis with relief of pain and improved function. chronic lyme arthritis occurs as the third stage of lyme disease. serologic testing and a history of a characteristic rash may be helpful in the diagnosis. radiographic and histopathologic findings are nonspecific, with both degenerative and inflammatory characteristics. intravenous antibiotics provide an effective tr ...	1992	1613242
western blotting for the diagnosis of borrelia burgdorferi infection in patients with sacroiliitis.		1992	1613726