Allergic responses induced by goat milk αS1-casein in a murine model of gastrointestinal atopy.

Up to 3% of young children develop milk allergy and this may influence the development of immune-mediated diseases in later life. One protein that has been associated with allergic reactions to ruminant milk is α(S1)-casein (CN). Studies suggest that goat milk with low levels of α(S1)-CN may reduce allergenicity of milk, but the dose response to α(S1)-CN has not been confirmed. In this study, we examined the immune response to varying levels of goat α(S1)-CN in a mouse model of gastrointestinal allergy. BALB/c mice (aged 5 wk) were given intraperitoneal injections with α(S1)-CN and aluminum as adjuvant at 1 and 3 wk to sensitize mice to the antigen. In wk 5, groups of fasting mice (n=8/group) were challenged 4 times on alternate days by intragastric gavage with saline or 2, 10, or 20mg of α(S1)-CN. Serum levels of specific IgE, IgG(1), and IgG(2a) antibodies and mouse mast cell protease-I were determined. Interleukin-4, IL-10, and IFN-γ responses to 48-h activation with antigen were measured in cultured splenocytes. We determined that mice sensitized with α(S1)-CN had higher titers of specific IgG(1) and IgE antibodies compared with controls; however, groups challenged with differing doses of α(S1)-CN did not differ. The group challenged with the highest dose of α(S1)-CN had a 10-fold increase in mouse mast cell protease-I compared with the group challenged with saline. Both IL-4 and IL-10 were produced in a dose-dependent manner by cultured splenocytes incubated with α(S1)-CN. Overall, α(S1)-CN stimulated the production of cytokines associated with allergic disease in a dose-dependent manner. Thus, milk with lower levels of α(S1)-CN should contribute to a lesser antigenic burden.

Adhesion molecule expression in the bovine mammary gland.

The bovine mammary gland requires lymphocytes for immune protection of the gland from foreign pathogens and, in addition, to transfer immune protection to the neonate via colostrum and milk. The process of homing primed lymphocytes to tissues is mediated by the interaction of cell-adhesion molecules displayed on the surface of lymphocytes and counter receptors displayed on the vascular endothelium. This study was conducted to identify the cell-adhesion molecules involved in homing lymphocytes to the bovine mammary gland at four different physiological stages; pregnant, colostral, lactation and involution. The expression and distribution of adhesion molecules in alveolar tissues and supramammary lymph nodes from the mammary glands of healthy cows was determined in situ by immunohistochemical analysis and compared with bovine Peyer's patch, used as a typical mucosal-associated lymphoid tissue and positive control. The mucosal addressin molecule, MAdCAM-1, was not detected in bovine mammary tissues at any of the four different physiological stages. Absence of MAdCAM-1 expression was verified by quantitative real-time RT-PCR analysis. Transcription levels of MAdCAM-1 mRNA were found to be more then 5 x 10(3)-fold lower in mammary alveolar tissues compared with bovine Peyer's patch tissues. In contrast to MAdCAM-1, phase-dependent protein expression of VCAM-1 was detected in both mammary alveolar tissues and the supramammary lymph nodes, with the highest expression observed in colostral phase cows. The protein expression in mammary alveolar tissues was limited to larger venules, although in colostral phase cows, VCAM-1 was also detected around the alveoli perimeter. In the supramammary lymph node, VCAM-1 protein was observed on both small and large venules. PNAd was detected in supramammary lymph nodes at all physiological stages of the mammary gland; however, it was not found in mammary alveolar tissues. Lymphocytes expressing beta7 were not detected in mammary tissues and lymphocytes expressing CD62L were only observed in the supramammary lymph nodes. Overall the data suggest that MAdCAM-1 and VCAM-1 are not involved in homing lymphocytes to the bovine mammary gland; whereas, VCAM-1 and PNAd may have this role in the supramammary lymph node.

A multicentre, randomised trial examining the effect of test procedures measuring emergence from post-traumatic amnesia.

BACKGROUND: Post-traumatic amnesia (PTA) tests that record different PTA durations in the same patient, thereby raising measurement accuracy issues, have been reported previously. A major problem lies in determining the end point of PTA. AIMS: To delineate areas of discrepancy in PTA tests and to provide independent verification for a criterion signalling emergence from PTA. METHODS: In a randomised design, two related PTA procedures were compared, one purportedly more difficult (Westmead PTA Scale, WPTAS) than the other (Modified Oxford PTA Scale, MOPTAS). Eighty two patients in the early stages of PTA were examined daily until emergence, by using the Galveston Orientation and Amnesia Test (GOAT) and the WPTAS/MOPTAS. A short battery of cognitive and behavioural measurements was made on three occasions: at the early stage of PTA (time 1), towards the end of PTA when the maximum score (12/12) was first obtained (time 2) and at the traditional criterion for emergence (scoring 12/12 for 3 consecutive days; time 3). RESULTS: No significant difference was recorded in PTA duration between the MOPTAS and WPTAS. Both scales recorded longer PTA durations than the GOAT. By using Kaplan-Meier survival analyses, the WPTAS was found to show a more protracted pattern of emergence at the end stage of PTA than the MOPTAS. A time lag of > or = 1 week in the resolution of disorientation as compared with amnesia was observed in 59% cases. Significant improvements occurred on all independent measurements between time 1 and time 2, but on only 2 of 5 cognitive measurements between time 2 and time 3. CONCLUSIONS: Although no significant differences in the duration of PTA on the MOPTAS/WPTAS were recorded, emergence from the late stages of PTA occurred more promptly with the MOPTAS. The need for inclusion of both orientation and memory items in PTA tests is highlighted by the frequency of disorientation-amnesia dissociations. The patterns of results on the independent measures suggest that patients who are in PTA for > 4 weeks have probably emerged from PTA when they first score 12/12 on the MOPTAS/WPTAS, and this criterion can replace the traditional criterion.

Development status of a next generation ECRIS: MARS-D at LBNL.

To demonstrate a Mixed Axial and Radial field System (MARS) as the best magnet scheme for future ECRISs, MARS-D, a demonstrative ECRIS using a NbTi MARS magnet is progressing at Lawrence Berkeley National Laboratory. An optimized MARS design can use either NbTi or Nb3Sn coils with reduced engineering complexities to construct the needed high-field magnets. The optimized magnet design could enhance MARS-D to a next generation ECRIS by producing minimum-B field maxima of 5.6 T axially and 3.2 T radially for operating frequencies up to 45 GHz. In-progress test winding has achieved a milestone demonstrating the fabrication feasibility of a MARS closed-loop coil.

Investigation on the electron flux to the wall in the VENUS ion source.

The long-term operation of high charge state electron cyclotron resonance ion sources fed with high microwave power has caused damage to the plasma chamber wall in several laboratories. Porosity, or a small hole, can be progressively created in the chamber wall which can destroy the plasma chamber over a few year time scale. A burnout of the VENUS plasma chamber is investigated in which the hole formation in relation to the local hot electron power density is studied. First, the results of a simple model assuming that hot electrons are fully magnetized and strictly following magnetic field lines are presented. The model qualitatively reproduces the experimental traces left by the plasma on the wall. However, it is too crude to reproduce the localized electron power density for creating a hole in the chamber wall. Second, the results of a Monte Carlo simulation, following a population of scattering hot electrons, indicate a localized high power deposited to the chamber wall consistent with the hole formation process. Finally, a hypervapotron cooling scheme is proposed to mitigate the hole formation in electron cyclotron resonance plasma chamber wall.

A novel polymorphism in the 5' flanking region of the glucose transporter (GLUT1) gene is strongly associated with diabetic nephropathy in patients with Type 1 diabetes mellitus.

Glucose transporter 1 (GLUT1) activity has been implicated in renal hypertrophy and extracellular matrix formation in mesangial cells. Recent studies have suggested that polymorphisms in the GLUT1 gene are associated with susceptibility to diabetic nephropathy (DN) in patients with diabetes mellitus. In this study, a novel polymorphism (A-2841T) in the 5' flanking region of GLUT1 was examined in 288 patients with Type 1 diabetes mellitus (T1DM) and 101 normal controls. The polymorphisms were amplified and the fragment digested with the enzyme HpyCH4V. There was a highly significant increase in the frequency of the TT-2841 genotype in patients with nephropathy (n=131) compared with those with either no microvascular complications after a 20-year duration of diabetes (uncomplicated; n=72; 54.5% vs. 2.7%, chi=79.4, P<.000001). There was no difference between the uncomplicated group and those who only had retinopathy (n=50; 2.7% vs. 4.0%, respectively). The frequency in recently diagnosed patients was 17.1% and only 2.0% in normal controls. In contrast, the AA genotype was found in 13.6% of the nephropaths, 76.3% of uncomplicated, 48.0% of retinopaths, and 65% of normal controls. These results confirm previous reports of an association between the GLUT1 gene and susceptibility to DN but not retinopathy. The localisation of this polymorphism suggests that it may be involved in the expression of the gene.

The HLA-E locus is associated with age at onset and susceptibility to type 1 diabetes mellitus.

Previous studies have suggested that the human leukocyte antigen (HLA) class I region may be involved in determining the age at onset and clinical severity of type 1 diabetes. We have investigated the frequency of polymorphisms of the nonclassical HLA class I gene, HLA-E, in 199 British Caucasian patients with type 1 diabetes and 82 healthy controls. A highly significant increase in the frequency of the HLA-E 0101 genotype was found in the patients compared to controls (chi(2) = 15.3, p < 0.00009). The frequency of the HLA-E 0101 genotype was increased in those patients diagnosed after 10 years of age, while the frequency of the 0101, 0103 genotype was significantly increased in those subjects diagnosed before 10 years of age (chi(2) = 26.0 p < 0.000003 and chi(2) = 13.0 p < 0.0003, respectively). No obvious interaction between the HLA-E locus and the class II DQB1*0201, 0302, and 0501 susceptibility alleles was found. This is the first report of an association between the HLA-E locus and susceptibility to an autoimmune disease.

A combined qualitative and quantitative procedure for the chemical analysis of urinary calculi.

A better understanding of the physico-chemical principles underlying the formation of calculus has led to a need for more precise information on the chemical composition of stones. A combined qualitative and quantitative procedure for the chemical analysis of urinary calculi which is suitable for routine use is presented. The procedure involves five simple qualitative tests followed by the quantitative determination of calcium, magnesium, inorganic phosphate, and oxalate. These data are used to calculate the composition of the stone in terms of calcium oxalate, apatite, and magnesium ammonium phosphate. Analytical results and derived values for five representative types of calculi are presented.

Measurement of the fasting urinary hydroxyproline: creatinine ratio in normal adults and its variation with age and sex.

Conditions for the determination of the fasting urinary hydroxyproline: creatinine ratio (OHPr: Cr ratio) have been examined, using a resin-catalysed hydrolysis and automated colorimetric procedure for the determination of hydroxyproline. Feeding experiments with gelatin showed that hydroxyproline is rapidly absorbed and excreted in the urine and that a 12-hour (overnight) fast is sufficient to ensure correct and reproducible fasting OHPr: Cr ratios. The mean fasting OHPr: Cr ratio decreased slightly with increasing age in both men and premenopausal women but there was no significant difference between the sexes. There was, however, a significant increase in the mean ratio in postmenopausal women. The normal range of fasting OHPr: Cr ratios for men and premenopausal women was found to be 0.003--0.015.

Plasma oxalic acid and calcium levels in oxalate poisoning.

Observations are reported on five cases of suicide or attempted suicide by poisoning with oxalic acid or ethylene glycol. Elevated oxalic acid levels were observed in the plasma, stomach contents, and a number of tissues. Raised oxalic acid levels in plasma were associated with reduced total and ultrafilterable calcium levels. It is suggested that the reduction in plasma total calcium level is due mainly to the deposition of calcium oxalate in the soft tissues, but inhibition of the parathyroid glands may be a contributory factor. Microscopic examination of various tissues indicated that oxalic acid is deposited in the tissues in two forms: (1) crystalline calcium oxalate dihydrate in the kidney and (2) a non-crystalline complex of calcium oxalate and lipid in liver and other tissues.

Seasonal variations in the composition of urine from normal subjects: a longitudinal study.

The volume, pH and composition of 24-h urine samples, collected by 13 healthy male adults, were followed over a period of one year. Significant and systematic variations in urine pH, calcium, phosphate, oxalate, uric acid, potassium and magnesium were observed. A significant but non-sinusoidal variation in sodium excretion was found but there were no significant changes in urinary volume, creatinine or hydroxyproline. Many of the observed changes could be attributed to variations in the pattern of food consumption throughout the year but calcium, phosphate and oxalate were exceptions in that seasonal variations in these parameters appeared to be due to the effects of sunlight (or vitamin D) rather than to the diet.

Intramedullary nailing in the treatment of open fractures of the tibia and fibula.

Intramedullary nailing of thirty acute displaced open fractures of the tibia and fibula resulted in union with only one superficial infection. The low incidence of sepsis is attributed to the use of the curved malleable Hodgkinson tibial nail which requires no reaming, renders the operation less difficult and traumatic, and interferes minimally with bone vascularity. Fibular nailing was an effective means of stabilizing nine of the twelve fractures close to the ankle joint.

Plasma electrolyte concentrations in women and the effects of oestrogen administration.

Age-related changes in the concentrations of the main plasma electrolytes and in the urinary excretion of some of these ions have been examined in 436 pre-menopausal and 117 post-menopausal women. The main changes up to the menopause were decreases in the mean plasma potassium, calcium and total protein concentrations, accompanied by increases in the renal excretion of calcium and inorganic phosphate. The decrease in plasma total calcium concentration was completely accounted for by the fall in albumin and globulin concentrations. The main changes observed at the menopause were increases in plasma sodium, total calcium, inorganic phosphate and magnesium concentrations, an increase in the plasma "anion gap" and increases in the renal excretion of sodium, magnesium and inorganic phosphate. All these changes were reversed by treatment with ethinyl oestradiol. The causes and significance of some of these changes are discussed, particularly the menopausal rises in plasma sodium concentration and in the plasma "anion gap".

Hypothesis. Biochemical changes at the menopause: possible role of the central nervous system.

Some of the biochemical changes which occur at the menopause can be attributed to an increased rate of loss of bone but others cannot be explained in this way. Data, collected through literature search, are presented which suggest that the rise in plasma phosphate concentration at the menopause is not due primarily to increased breakdown of bone but rather to the following sequence of events: progesterone deficiency----respiratory hypoventilation----mild respiratory acidosis and hypoxia----compensatory metabolic alkalosis----altered carbohydrate metabolism----rise in plasma phosphate concentration. Increases in the concentration of many plasma constituents occur at the menopause, which appear to be due to fluid loss and haemoconcentration. A possible cause of these changes is a reduced secretion of vasopressin by the pituitary gland as a result of oestrogen deficiency. Increases in the fasting urinary excretion of phosphate, sodium and magnesium also occur at the menopause. These changes cannot be attributed to increased bone loss but could be due to the effects of oestrogen deficiency on circadian rhythms in the hypothalamus.

Changes in plasma sodium concentration in women at the menopause.

A significant increase in the mean plasma sodium concentration and in the fasting urinary Na/Cr ratio was observed in healthy women at the menopause. Both of these changes were reversed by administering oestrogens. None of the above effects appeared to be due to alterations in sodium intake or in renal glomerular function. The most likely cause of the increase in plasma sodium concentration at the menopause appeared to be a decrease in plasma volume since there were also significant increases in the mean plasma albumin and total protein concentrations.

Increase in plasma lactate at the menopause and its relation to the "anion gap".

The mean plasma anion gap (Na + K + Ca + Mg)--(Cl + HCO3(-) + HPO4(2-) + protein), was significantly higher in post-menopausal women compared with pre-menopausal women (8.04 mEq/l compared with 7.03 mEq/l). This change was due, in part, to an increase in the plasma lactate concentration and to smaller increases in citrate and pyruvate concentrations. There were also changes in bicarbonate and chloride concentrations which suggested an increase pH of approximately 0.02 U. Together, these changes accounted for 46% of the increase in the "anion gap", leaving 54% unexplained. It is suggested that the rise in plasma lactate concentration may be due to mild alkalosis and that this change may account for the rise in plasma urate concentration which also occurs at the menopause.

Direct determination of theophylline in serum by fluoroimmunoassay using highly specific antibodies.

Described is the development of a fluoroimmunoassay for theophylline using a fluorescein labelled derivative of theophylline as tracer and antibodies coupled to magnetizable solid-phase particles. Three approaches are described for the preparation of antibodies for theophylline, of which one produced highly specific, high titre antibodies. The fluoroimmunoassay using these antibodies required a 10 microL sample, reached equilibrium within 5 min, and the results correlated closely with those of an established enzymoimmunoassay method. Potentially interfering endogenous fluorophores from the serum sample were reliably removed at the separation step of the bound and free fractions. There was no significant cross-reactivity with all other structurally related compounds.

A comparison of the effects of lactose and of two chemically modified waxy maize starches on mineral metabolism in the rat.

Diets containing 30% by weight of waxy maize starch, lactose monohydrate, acetylated distarch phosphate (EEC No. 1414) or acetylated distarch adipate (EEC No. 1422) were fed to weanling female Specified Pathogen-Free Sprague-Dawley rats for 1 yr and to similar 9-month-old rats for 34 wk. Behaviour and general health were unaffected by the different diets and there were no diet-related differences in food consumption. AT the end of the experiment with 9-month-old rats the mean body weight of the animals receiving lactose was significantly lower than that of the controls receiving starch. The animals receiving the modified starches were slightly but not significantly heavier than the controls at the end of both experiments. The main treatment-related changes in rats on the three test diets were (1) caecal enlargement, (2) increased urinary excretion of calcium, (3) increased renal calcification as measured by chemical analysis of renal tissue obtained at autopsy and (4) increased medullary and pelvic nephrocalcinosis as assessed histopathologically. Acetylated distarch adipate had a slightly greater effect on the above parameters than acetylated distarch phosphate but both modified starches had less effect than lactose. The calcium content of the kidneys, as measured by chemical analysis or histopathology, increased with age, even in the animals receiving the control diet. This change may be due to excessively high concentrations of calcium and phosphorus in all the diets, including the control diet. Cortico-medullary mineral deposits were not a feature in these studies possibly because the diets were not deficient in magnesium. The importance of correct dietary formulation in long-term toxicity studies is emphasized.

Linking public health education and practice: the Australian experience.

The public health workforce in Australia is highly skilled, multifunctional, and drawn from a variety of backgrounds, including clinical practice and non-health areas. A wide range of activities is needed to meet the educational and training requirements of this workforce, including on the job inservice training, context specific continuing education programs and short courses, distance and self-directed learning packages, and postgraduate University level courses. The core components of public health today include: a social and political commitment to health, a shared responsibility between government and the public, and a multidisciplinary field of action. The challenge for those providing education and training for the public health workforce is to ensure graduates have the broad range of knowledge and skills needed in this climate. A system-wide approach to learning, where knowledge and skill development is related to the practices and settings of service and program delivery, will ensure strong links between education and practice.

Tackling the tobacco challenge: achieving 'healthy public policy' in tobacco control in Guernsey.

Scientific evidence identifying smoking as the major cause of poor health and premature death in both industrialised and increasingly in developing countries is now overwhelming. Despite this, for a variety of reasons, there has been reluctance amongst many Governments including that of Britain, to take all logical action necessary to restrict and reduce smoking, especially amongst the young. The States of Guernsey in the Channel Islands has recently agreed to introduce an integrated package of measures designed specifically to make smoking less attractive and less accessible and less affordable to young people in an attempt to reduce the number of addicted adult smokers. These measures include a total ban of all public advertising of tobacco, apart from at point of sale, a substantial price rise followed by further price rises for a minimum period of five years, a raising of the minimum age for the purchase of tobacco from 16 to 18 years, an increase in the size and content of pack health warnings, and increased funding for specific nonsmoking health promotion activities. The various barriers to achieving these reforms are described.