Short communication: Screening stable flies and house flies as potential vectors of digital dermatitis in dairy cattle.

Digital dermatitis is a bacterial infection that causes lesions above the heel bulbs on cattle hooves, and several bacterial species from the genus Treponema are suspected to be causative agents of this polymicrobial condition. Transmission of the bacteria to healthy cows is understudied, particularly with regard to potential insect vectors. Therefore, the objective of this research was to determine if flies captured from a dairy farm known to have digital dermatitis are contaminated with Treponema bacteria. The DNA-based assays did not detect any Treponema phagedenis from stable flies and house flies collected at a dairy experiencing an outbreak of digital dermatitis. Other potential means of bacterial transmission are discussed.

Corticostriatal circuit defects in Hoxb8 mutant mice.

Hoxb8 mutant mice exhibit compulsive grooming and hair removal dysfunction similar to humans with the obsessive-compulsive disorder (OCD)-spectrum disorder, trichotillomania. As, in the mouse brain, the only detectable cells that label with Hoxb8 cell lineage appear to be microglia, we suggested that defective microglia cause the neuropsychiatric disorder. Does the Hoxb8 mutation in microglia lead to neural circuit dysfunctions? We demonstrate that Hoxb8 mutants contain corticostriatal circuit defects. Golgi staining, ultra-structural and electrophysiological studies of mutants reveal excess dendritic spines, pre- and postsynaptic structural defects, long-term potentiation and miniature postsynaptic current defects. Hoxb8 mutants also exhibit hyperanxiety and social behavioral deficits similar to mice with neuronal mutations in Sapap3, Slitrk5 and Shank3, reported models of OCD and autism spectrum disorders (ASDs). Long-term treatment of Hoxb8 mutants with fluoxetine, a serotonin reuptake inhibitor, reduces excessive grooming, hyperanxiety and social behavioral impairments. These studies provide linkage between the neuronal defects induced by defective Hoxb8-microglia and neuronal dysfunctions directly generated by mutations in synaptic components that result in mice, which display similar pathological grooming, hyperanxiety and social impairment deficits. Our results shed light on Hoxb8 microglia-driven circuit-specific defects and therapeutic approaches that will become essential to developing novel therapies for neuropsychiatric diseases such as OCD and ASDs with Hoxb8-microglia being the central target.

Automated estrous detection using multiple commercial precision dairy monitoring technologies in synchronized dairy cows.

Estrus in dairy cattle varies in duration and intensity, highlighting the need for accurate and continuous monitoring to determine optimal breeding time. The objective of this study was to evaluate precision dairy monitoring technologies (PDMT) for detecting estrus. Estrus was synchronized in lactating Holstein cows (n = 109) using a modified G7G-Ovsynch protocol (last GnRH injection withheld to permit expression of estrus) beginning at 45 to 85 d in milk. Resumption of ovarian cyclicity at enrollment was verified by transrectal ultrasonography for presence of a corpus luteum. Cows were observed visually during 30 min (4 times per day) for behavioral estrus on d -1 to 2 (d 0 = day of estrus). Periods peri-estrus were defined by the temporal blood plasma progesterone patterns on d -5, -4, -3, -2, -1, 0, 2, 4, 6, and 8. Estrous detection by PDMT, an estrous behavior scoring system, and by visual observation of standing estrus were compared with the reference (gold) standard. Only 56% of cows that ovulated were observed standing by visual observation. Sensitivity and specificity for estrous detection were not different among all PDMT. Devices in this study measuring activity in steps, neck movement, high activity of head movement, or a proprietary motion index increased on the day of estrus 69 to 170% from the baseline before estrus. The change in rumination time on the day of estrus decreased for both neck and ear-based technologies (-2 to -16%). Temperature of the reticulorumen, vagina, and ear skin were not different on the day of estrus than day peri-estrus. Daily lying times decreased on average to 24.6% on the day of estrus for IceQube (IceRobotics Ltd., Edinburgh, Scotland). In contrast, lying time increased 15.5 and 33.1% for AfiAct Pedometer Plus (Afimilk, Kibbutz Afikim, Israel) and Track a Cow (ENGS Systems Innovative Dairy Solutions, Rosh Pina, Israel), respectively. All PDMT tested were capable of detecting estrus at least as effectively as visual observation. Four of the 6 PDMT that reported estrous alerts correctly detected 15 to 35% more cows than visual observation 4 times per day. Use of temporal progesterone patterns correctly identified more cows than visual observation alone. Dairy producers considering PDMT should focus on (1) the reference (gold) standard used to test efficacy of a device's alerts and (2) the device that will have the fewest false readings in their operations.

Corticostriatal circuit defects in Hoxb8 mutant mice.

This corrects the article DOI: 10.1038/mp.2017.180.

Technical note: Evaluation of an ear-attached real-time location monitoring system.

Position tracking of cows within the barn environment allows for determining behavioral patterns and activities. Such data might be used for detection of estrus and disease. A newly marketed real-time location monitoring system (Smartbow, Smartbow GmbH, Weibern, Austria) was tested in this study. Cow location was continuously monitored with the Smartbow tags mounted on the cow's ear, which sends low-frequency signals to receivers further transmitting the information to a server. Through incoming data, the server triangulates the location of the cow within the barn environment in real time. The validation of the system was carried out in 4 steps. The first 2 steps served as static testing steps (tags and 1 cow positioned at 30 reference points), and steps 3 and 4 were dynamic steps with cows moving in the barn environment. For 48 h, locations of 15 cows were confirmed each hour by laser measurements performed by a team (step 3) or 1 observer (step 4). Interobserver variability was 0.83 m (range: 0.05 to 2.87 m), and intraobserver variability had a range of 0.02 to 0.31 m. In the 4 validation steps, the mean distance between observer laser measurements and Smartbow was between 1.22 and 1.80 m. Step 4, with 334 observations, resulted in a mean distance difference of 1.22 m (standard error = 1.32 m). Data can be used for development of algorithms to detect sick cows with changed behavioral patterns. Data may also be used to monitor cow responses to physical environment, potentially improving facility design. Time budgets in proximity to important barn features (i.e., feed bunk and water trough) and distances traveled can be calculated and used to identify cows in need of caretaker's attention and identify the cow's exact location in the barn.

Influence of breed, milk yield, and temperature-humidity index on dairy cow lying time, neck activity, reticulorumen temperature, and rumination behavior.

The objective of this study was to compare weekly mean lying time (LT), neck activity (NA), reticulorumen temperature (RT), and rumination time (RU) among 3 breed groups, milk yield (MY), and temperature-humidity index (THI). Cows (n = 36; 12 Holstein, 12 crossbred, and 12 Jersey) were blocked by parity group (primiparous or multiparous), days in milk, and MY. Lying time, NA, RT, RU, and MY were recorded and averaged by day and then by week for each cow. For study inclusion, each cow was required to have 10 wk of LT, NA, RT, and RU data. Maximum THI were recorded and averaged daily. Mean (±SE) days in milk, LT, MY, RT, RU, NA, and maximum THI were 159.0 ± 6.0 d, 11.1 ± 0.1 h/d, 28.7 ± 0.5 kg/d, 38.8 ± 0.0°C, 6.4 ± 0.1 h/d, 323.8 ± 3.8 activity units, and 56.5 ± 0.6, respectively. The MIXED Procedure of SAS (SAS Institute Inc., Cary, NC) was used to evaluate fixed effects of breed, MY, parity, THI, and their interactions on LT, NA, RT, and RU with cow nested within breed as subject. All main effects remained in each model regardless of significance level. Stepwise backward elimination was used to remove nonsignificant interactions. The interactions of breed × parity group and maximum THI × parity group were associated with RT. Increasing THI coincided with increasing RT. Least squares means LT for multiparous cows was significantly greater than LT for primiparous cows (11.4 ± 0.3 and 10.5 ± 0.5 h/d, respectively). Least squares means NA for primiparous cows was greater than for multiparous cows of all breeds (372.1 ± 10.9 and 303.4 ± 7.8, respectively). The CORR Procedure of SAS was used to evaluate relationships among RT, RU, LT, NA, and MY. Rumination time was positively correlated with MY (r = 0.30) and negatively correlated with LT (r = -0.14). Reticulorumen temperature was negatively correlated with MY (r = -0.11). Rumination time was positively correlated with NA (r = 0.18) and negatively correlated with LT (r = -0.14). Lying time and NA were negatively correlated (r = -0.43). Neck activity was positively correlated with MY (r = 0.14). Lying time was negatively correlated with MY (r = -0.25). Milk yield was associated with RU, which may be related to cows with greater MY also having a greater feed intake. Lying time increased and NA decreased with increasing parity, which may be effects of social hierarchy, where primiparous cows are more susceptible to being pushed away from the feed bunk and freestalls. Milk yield was positively associated with RU. Greater milk production requires greater feed intake, which may result in longer RU than for low-yielding cows. Lying time decreased as milk yield increased. The behavioral and physiological differences observed in this study provide new insight into the effects that breed, parity, MY, and THI have on cows.

Retinal remodeling in human retinitis pigmentosa.

Retinitis Pigmentosa (RP) in the human is a progressive, currently irreversible neural degenerative disease usually caused by gene defects that disrupt the function or architecture of the photoreceptors. While RP can initially be a disease of photoreceptors, there is increasing evidence that the inner retina becomes progressively disorganized as the outer retina degenerates. These alterations have been extensively described in animal models, but remodeling in humans has not been as well characterized. This study, using computational molecular phenotyping (CMP) seeks to advance our understanding of the retinal remodeling process in humans. We describe cone mediated preservation of overall topology, retinal reprogramming in the earliest stages of the disease in retinal bipolar cells, and alterations in both small molecule and protein signatures of neurons and glia. Furthermore, while Müller glia appear to be some of the last cells left in the degenerate retina, they are also one of the first cell classes in the neural retina to respond to stress which may reveal mechanisms related to remodeling and cell death in other retinal cell classes. Also fundamentally important is the finding that retinal network topologies are altered. Our results suggest interventions that presume substantial preservation of the neural retina will likely fail in late stages of the disease. Even early intervention offers no guarantee that the interventions will be immune to progressive remodeling. Fundamental work in the biology and mechanisms of disease progression are needed to support vision rescue strategies.

Role of mechanical ventilation in the airborne transmission of infectious agents in buildings.

Infectious disease outbreaks and epidemics such as those due to SARS, influenza, measles, tuberculosis, and Middle East respiratory syndrome coronavirus have raised concern about the airborne transmission of pathogens in indoor environments. Significant gaps in knowledge still exist regarding the role of mechanical ventilation in airborne pathogen transmission. This review, prepared by a multidisciplinary group of researchers, focuses on summarizing the strengths and limitations of epidemiologic studies that specifically addressed the association of at least one heating, ventilating and/or air-conditioning (HVAC) system-related parameter with airborne disease transmission in buildings. The purpose of this literature review was to assess the quality and quantity of available data and to identify research needs. This review suggests that there is a need for well-designed observational and intervention studies in buildings with better HVAC system characterization and measurements of both airborne exposures and disease outcomes. Studies should also be designed so that they may be used in future quantitative meta-analyses.

Bacterial communities in commercial aircraft high-efficiency particulate air (HEPA) filters assessed by PhyloChip analysis.

UNLABELLED: Air travel can rapidly transport infectious diseases globally. To facilitate the design of biosensors for infectious organisms in commercial aircraft, we characterized bacterial diversity in aircraft air. Samples from 61 aircraft high-efficiency particulate air (HEPA) filters were analyzed with a custom microarray of 16S rRNA gene sequences (PhyloChip), representing bacterial lineages. A total of 606 subfamilies from 41 phyla were detected. The most abundant bacterial subfamilies included bacteria associated with humans, especially skin, gastrointestinal and respiratory tracts, and with water and soil habitats. Operational taxonomic units that contain important human pathogens as well as their close, more benign relatives were detected. When compared to 43 samples of urban outdoor air, aircraft samples differed in composition, with higher relative abundance of Firmicutes and Gammaproteobacteria lineages in aircraft samples, and higher relative abundance of Actinobacteria and Betaproteobacteria lineages in outdoor air samples. In addition, aircraft and outdoor air samples differed in the incidence of taxa containing human pathogens. Overall, these results demonstrate that HEPA filter samples can be used to deeply characterize bacterial diversity in aircraft air and suggest that the presence of close relatives of certain pathogens must be taken into account in probe design for aircraft biosensors. PRACTICAL IMPLICATIONS: A biosensor that could be deployed in commercial aircraft would be required to function at an extremely low false alarm rate, making an understanding of microbial background important. This study reveals a diverse bacterial background present on aircraft, including bacteria closely related to pathogens of public health concern. Furthermore, this aircraft background is different from outdoor air, suggesting different probes may be needed to detect airborne contaminants to achieve minimal false alarm rates. This study also indicates that aircraft HEPA filters could be used with other molecular techniques to further characterize background bacteria and in investigations in the wake of a disease outbreak.

Computational molecular phenotyping of retinal sheet transplants to rats with retinal degeneration.

Retinal progenitor sheet transplants have been shown to extend neuronal processes into a degenerating host retina and to restore visual responses in the brain. The aim of this study was to identify cells involved in transplant signals to retinal degenerate hosts using computational molecular phenotyping (CMP). S334ter line 3 rats received fetal retinal sheet transplants at the age of 24-40 days. Donor tissues were incubated with slow-releasing microspheres containing brain-derived neurotrophic factor or glial cell-derived neurotrophic factor. Up to 265 days after surgery, eyes of selected rats were vibratome-sectioned through the transplant area (some slices stained for donor marker human placental alkaline phosphatase), dehydrated and embedded in Eponate, sectioned into serial ultrathin datasets and probed for rhodopsin, cone opsin, CRALBP (cellular retinaldehyde binding protein), l-glutamate, l-glutamine, glutathione, glycine, taurine, γ-aminobutyric acid (GABA) and DAPI (4',6-diamidino-2-phenylindole). In large transplant areas, photoreceptor outer segments in contact with host retinal pigment epithelium revealed rod and cone opsin immunoreactivity whereas no such staining was found in the degenerate host retina. Transplant photoreceptor layers contained high taurine levels. Glutamate levels in the transplants were higher than in the host retina whereas GABA levels were similar. The transplant inner nuclear layer showed some loss of neurons, but amacrine cells and horizontal cells were not reduced. In many areas, glial hypertrophy between the host and transplant was absent and host and transplant neuropil appeared to intermingle. CMP data indicate that horizontal cells and both glycinergic and GABAergic amacrine cells are involved in a novel circuit between transplant and host, generating alternative signal pathways between transplant and degenerating host retina.

The Viking viewer for connectomics: scalable multi-user annotation and summarization of large volume data sets.

Modern microscope automation permits the collection of vast amounts of continuous anatomical imagery in both two and three dimensions. These large data sets present significant challenges for data storage, access, viewing, annotation and analysis. The cost and overhead of collecting and storing the data can be extremely high. Large data sets quickly exceed an individual's capability for timely analysis and present challenges in efficiently applying transforms, if needed. Finally annotated anatomical data sets can represent a significant investment of resources and should be easily accessible to the scientific community. The Viking application was our solution created to view and annotate a 16.5 TB ultrastructural retinal connectome volume and we demonstrate its utility in reconstructing neural networks for a distinctive retinal amacrine cell class. Viking has several key features. (1) It works over the internet using HTTP and supports many concurrent users limited only by hardware. (2) It supports a multi-user, collaborative annotation strategy. (3) It cleanly demarcates viewing and analysis from data collection and hosting. (4) It is capable of applying transformations in real-time. (5) It has an easily extensible user interface, allowing addition of specialized modules without rewriting the viewer.

Detection of respiratory viruses on air filters from aircraft.

AIMS: To evaluate the feasibility of identifying viruses from aircraft cabin air, we evaluated whether respiratory viruses trapped by commercial aircraft air filters can be extracted and detected using a multiplex PCR, bead-based assay. METHODS AND RESULTS: The ResPlex II assay was first tested for its ability to detect inactivated viruses applied to new filter material; all 18 applications of virus at a high concentration were detected. The ResPlex II assay was then used to test for 18 respiratory viruses on 48 used air filter samples from commercial aircraft. Three samples tested positive for viruses, and three viruses were detected: rhinovirus, influenza A and influenza B. For 33 of 48 samples, internal PCR controls performed suboptimally, suggesting sample matrix effect. CONCLUSION: In some cases, influenza and rhinovirus RNA can be detected on aircraft air filters, even more than 10 days after the filters were removed from aircraft. SIGNIFICANCE AND IMPACT OF THE STUDY: With protocol modifications to overcome PCR inhibition, air filter sampling and the ResPlex II assay could be used to characterize viruses in aircraft cabin air. Information about viruses in aircraft could support public health measures to reduce disease transmission within aircraft and between cities.

Effect of shape and coating of a subretinal prosthesis on its integration with the retina.

Retinal stimulation with high spatial resolution requires close proximity of electrodes to target cells. This study examines the effects of material coatings and 3-dimensional geometries of subretinal prostheses on their integration with the retina. A trans-scleral implantation technique was developed to place microfabricated structures in the subretinal space of RCS rats. The effect of three coatings (silicon oxide, iridium oxide and parylene) and three geometries (flat, pillars and chambers) on the retinal integration was compared using passive implants. Retinal morphology was evaluated histologically 6 weeks after implantation. For 3-dimensional implants the retinal cell phenotype was also evaluated using Computational Molecular Phenotyping. Flat implants coated with parylene and iridium oxide were generally well tolerated in the subretinal space, inducing only a mild gliotic response. However, silicon-oxide coatings induced the formation of a significant fibrotic seal around the implants. Glial proliferation was observed at the base of the pillar electrode arrays and inside the chambers. The non-traumatic penetration of pillar tips into the retina provided uniform and stable proximity to the inner nuclear layer. Retinal cells migrated into chambers with apertures larger than 10 mum. Both pillars and chambers achieved better proximity to the inner retinal cells than flat implants. However, isolation of retinal cells inside the chamber arrays is likely to affect their long-term viability. Pillars demonstrated minimal alteration of the inner retinal architecture, and thus appear to be the most promising approach for maintaining close proximity between the retinal prosthetic electrodes and target neurons.

Cyclic changes in insulin needs of an unstable diabetic.

The fluctuating insulin requirements of an unstable diabetic over an 8-year period have been subjected to spectral analysis. There is evidence of cyclic changes of several different period lengths in addition to red noise. The periodicities indicate that social causes play no major role but suggest that a weathermediated effect may exist.

Extreme retinal remodeling triggered by light damage: implications for age related macular degeneration.

PURPOSE: Our objective was to comprehensively assess the nature and chronology of neural remodeling in retinal degenerations triggered by light-induced retinal damage (LIRD) in adult albino rodents. Our primary hypothesis is that all complete photoreceptor degenerations devolve to extensive remodeling. An hypothesis emergent from data analysis is that the LIRD model closely mimics late-stage atrophic age relared macular degeneration (AMD). METHODS: Sprague-Dawley (SD) rats received intense light exposures of varied durations and survival times ranging from 0 to 240 days. Remodeling was visualized by computational molecular phenotyping (CMP) of a small molecule library: 4-aminobutyrate (gamma), arginine (R), aspartate (D), glutamate (E), glutamine (Q), glutathione (J), glycine (G), and taurine (tau). This library was augmented by probes for key proteins such as rod opsin, cone opsin and cellular retinal binding protein (CRALBP). Quantitative CMP was used to profile 160 eyes from 86 animals in over 6,000 sections. RESULTS: The onset of remodeling in LIRD retinas is rapid, with immediate signs of metabolic stress in photoreceptors, the retinal pigmented epithelium (RPE), the choriocapillaris, and Müller cells. In particular, anomalous elevated aspartate levels appear to be an early stress marker in photoreceptors. After the stress phase, LIRD progresses to focal photoreceptor degeneration within 14 days and extensive remodeling by 60 days. RPE and choriocapillaris losses parallel Müller cell distal seal formation, with progressive neuronal migration, microneuroma evolution, fluid channel formation, and slow neuronal death. The remaining retina in advanced light damage can be classified as survivor, light damage (LD), or decimated zones where massive Müller cell and neuronal emigration into the choroid leaves a retina depleted of neurons and Müller cells. These zones and their transitions closely resemble human geographic atrophy. Across these zones, Müller cells manifest extreme changes in the definitive Müller cell tauQE signature, as well as CRALBP and arginine signals. CONCLUSIONS: LIRD retinas manifest remodeling patterns of genetic retinal degeneration models, but involve no developmental complexities, and are ultimately more aggressive, devastating the remaining neural retina. The decimation of the neural retina via cell emigration through the perforated retina-choroid interface is a serious denouement. If focal remodeling in LIRD accurately profiles late stage atrophic age-related macular degenerations, it augurs poorly for simple molecular interventions. Indeed, the LIRD profile in the SD rat manifests more similarities to advanced human atrophic AMD than most genetically or immunologically induced murine models of AMD.

Graffinity: Visualizing Connectivity in Large Graphs.

Multivariate graphs are prolific across many fields, including transportation and neuroscience. A key task in graph analysis is the exploration of connectivity, to, for example, analyze how signals flow through neurons, or to explore how well different cities are connected by flights. While standard node-link diagrams are helpful in judging connectivity, they do not scale to large networks. Adjacency matrices also do not scale to large networks and are only suitable to judge connectivity of adjacent nodes. A key approach to realize scalable graph visualization are queries: instead of displaying the whole network, only a relevant subset is shown. Query-based techniques for analyzing connectivity in graphs, however, can also easily suffer from cluttering if the query result is big enough. To remedy this, we introduce techniques that provide an overview of the connectivity and reveal details on demand. We have two main contributions: (1) two novel visualization techniques that work in concert for summarizing graph connectivity; and (2) Graffinity, an open-source implementation of these visualizations supplemented by detail views to enable a complete analysis workflow. Graffinity was designed in a close collaboration with neuroscientists and is optimized for connectomics data analysis, yet the technique is applicable across domains. We validate the connectivity overview and our open-source tool with illustrative examples using flight and connectomics data.

Different Toll-like receptor agonists induce distinct macrophage responses.

We previously reported that gram-negative bacterial lipopolysaccharide (LPS) activates cells via Toll-like receptor (TLR) 4, whereas the mycobacterial cell wall glycolipid lipoarabinomannan (LAM) activates cells via TLR2. We also identified a secreted TLR2 agonist activity in short-term culture filtrates of Mycobacterium tuberculosis bacilli, termed soluble tuberculosis factor (STF). Here we show that STF contains mannosylated phosphatidylinositol (PIM) and that purified PIM possesses TLR2 agonist activity. Stimulation of RAW 264.7 macrophages by LPS, LAM, STF, and PIM rapidly activated nuclear factor (NF)-kappaB, activator protein-1 (AP-1), and mitogen-activated protein (MAP) kinases. These TLR agonists induced similar levels of NF-kappaB and AP-1 DNA-binding activity, as well as trans-activation function. Unexpectedly, these TLR agonists induced tumor necrosis factor alpha secretion, whereas only LPS was capable of inducing interleukin-1beta and nitric oxide secretion. Thus, different TLR proteins are still capable of activating distinct cellular responses, in spite of their shared capacities to activate NF-kappaB, AP-1, and MAP kinases.

Mechanism of exercise-induced hypoxemia in horses.

Arterial hypoxemia has been reported in horses during heavy exercise, but its mechanism has not been determined. With the use of the multiple inert gas elimination technique, we studied five horses, each on two separate occasions, to determine the physiological basis of the hypoxemia that developed during horizontal treadmill exercise at speeds of 4, 10, 12, and 13-14 m/s. Mean, blood temperature-corrected, arterial PO2 fell from 89.4 Torr at rest to 80.7 and 72.1 Torr at 12 and 13-14 m/s, respectively, whereas corresponding PaCO2 values were 40.3, 40.3, and 39.2 Torr. Alveolar-arterial PO2 differences (AaDO2) thus increased from 11.4 Torr at rest to 24.9 and 30.7 Torr at 12 and 13-14 m/s. In 8 of the 10 studies there was no change in ventilation-perfusion (VA/Q) relationships with exercise (despite bronchoscopic evidence of airway bleeding in 3) and total shunt was always less than 1% of the cardiac output. Below 10 m/s, the AaDO2 was due only to VA/Q mismatch, but at higher speeds, diffusion limitation of O2 uptake was increasingly evident, accounting for 76% of the AaDO2 at 13-14 m/s. Most of the exercise-induced hypoxemia is thus the result of diffusion limitation with a smaller contribution from VA/Q inequality and essentially none from shunting.

Diagnostic problem caused by an atypical creatine kinase isoenzyme in a patient with myocardial infarction.

This report describes the diagnostic problem caused by an atypical immunoglobulin-bound creatine kinase isoenzyme in a patient who had a myocardial infarction. In the presence of this atypical isoenzyme, creatine kinase isoenzyme electrophoresis was of no help in determining whether myocardial infarction had occurred. A diagnosis of myocardial infarction was confirmed by carrying out lactate dehydrogenase isoenzyme electrophoresis and finding the characteristic increase in LD1/LD2 ratio and by following the total creatine kinase, aspartate aminotransferase and lactate dehydrogenase activities over a 5-day period. Further investigations were carried out which characterized the atypical isoenzyme as an uncommon type: creatine kinase-BB bound to immunoglobulin A lambda.

Gingival and bacterial plaque response to instrumentation, oral hygiene instruction and nutritional therapy.

Thirty-three male subjects participated in a study to examine the effect of supplements of multiple vitamins and minerals, local therapy (periodontal instrumentation and oral hygiene instruction) and a combination of both on gingival inflammation and bacterial plaque formation. Subjects were given either multivitamin and mineral supplements or placebos on a double-blind basis for 21 days. On Day 7, the mandibular incisors were instrumented, and each subject was instructed in brushing and flossing. Observations were taken at Days 0, 7 and 21. There was a significant (P = 0.004) effect from micronutrient supplementation at Day 7 on the gingival index but no significant effect on the plaque index. On Day 21 there was no statistical superiority noted for the supplemented group in respect to either the gingival or plaque index, although the gingival index approached significance (P = 0.062).