Identification and characterization of the genes encoding human and mouse osteoactivin.

Osteoactivin (OA) is more highly expressed in the bones of osteopetrotic mutant rats (op/op) than in those of their normal littermates and is the homologue of human nmb, a cDNA more highly expressed in melanoma-derived cell lines of low metastatic potential, and of mouse DC-HIL, which has been implicated in endothelial cell adhesion. The human OA gene is found on chromosome 7p15.1 and consists of 11 exons spanning 28.3 kb. Murine OA is encoded by a highly similar gene of 11 exons spanning 20.2 kb on mouse chromosome 6. Human OA uses the same transcriptional initiation site in both bone and kidney as was reported for melanoma cells. OA is expressed in primary human and mouse osteoblast cultures at all stages of differentiation, with increased levels observed concurrently with the expression of osteoblast phenotype markers. OA is also expressed in a wide variety of human and mouse tissues as determined by RT-PCR analysis. Immunohistochemical investigation of OA expression in late mouse embryonic development showed very high, cell-specific expression in the nervous system, basal layer of the skin, germinal cells of hair follicles, and in the forming nephrons of the kidney. Continuing investigation of the cell-specific expression of OA in bone as well as in other tissues will lead to a better understanding of its function in the development of these cell types.

Medicine for the twenty-first century: challenges in personal and public health promotion.

Over the last two decades, definitions of health and what creates health have changed dramatically. Health promotion concepts and practices have been in the forefront of that change and have had considerable impact on how health is viewed and what contributes to it. The fact remains, however, that, at this point, its true potential is largely unrealized. Canada has played a significant role in the development of health promotion internationally through cosponsorship of the First International Conference on Health Promotion in 1986, which produced the Ottawa Charter, and nationally through the release of Achieving Health for All: A Framework for Health Promotion in the same year. I review the background of health promotion from an international perspective, but I focus on the Canadian experience. Drawing on experience gained over many years of attempting to implement health promotion and analyze its impact, I present current issues and emphasize the need for strategic direction.

A Polynesian family showing co-dominant inheritance of normal glycophorin C and the Gerbich variant form of glycophorin C.

Two individuals with the rare Ge:-2-3,4 phenotype (Gerbich type of Gerbich negative) were identified in a family of Polynesian descent who reside in the Cook Islands. In initial serologic tests, all other family members typed as Ge-positive, and heterozygous individuals could not be identified. Further studies on blood samples from seven members of this Polynesian family by immunoblotting and hemagglutination tests on trypsin-treated red blood cells showed that normal glycophorin C and the product of the Gerbich allele were inherited in an autosomal dominant manner.

Acute transfusion reactions.

We reviewed 1500 acute transfusion reactions that were reported to the Auckland Regional Blood centre over a 7 year period, from approximately 440,000 transfusions. The majority of reactions were to red cells, and these had the highest reaction incidence per unit (0.73%) of all blood products. The reaction incidence per unit transfused for plasma was 0.1%, for stable plasma protein solution 0.01%, and for platelets 0.04%. The majority of symptoms reported were mild and transient. The commonest were fever (72%), rigors (33%), and rash or urticaria (30%). Although more serious reactions were reported such as angioedema, hypotension and pulmonary oedema, none of these were severe, as judged from the data reported to the centre. There were two transfusion related deaths during the study period, one due to an ABO incompatible transfusion, the other due to bacterial contamination of a unit of blood. Leucocyte agglutinins or antibodies were detected in 29% of those with a febrile reaction, but were also detected in 22% of those who remained afebrile. Serological abnormalities that may have accounted for the reaction were only detected in 12 patients six of whom had autoantibodies. As laboratory investigation reveals little that accurately defines the aetiology of a reaction, a rationalisation of the investigation into acute transfusion reactions is suggested.

Free antibody after low dose Rh immunoprophylaxis.

Eighty Rh negative women delivering Rh positive babies were screened for red cell antibodies after their routine postnatal dose of 125 micrograms 7S anti D immunoglobulin. In all 80 free antibody could be detected. Distribution of titres by anti-human globulin (indirect Coombs) and ficin techniques were uninfluenced by ABO incompatibility, fetal cell counts, maternal weight or sampling time in the few days after immunoprophylaxis. Quantitations determined by autoanalyser showed some correlation with these variables. It is suggested that screening for free antibody is not the appropriate test to detect large fetomaternal spills which would warrant additional immunoprophylaxis.

A prelude to health for all.

A seminal report produced in Canada during 1974 has helped to diminish the dominance of the medical model for health systems.

PIP: In an attempt to explain why some people were healthy and others were not, Canada's Minister of Health and Welfare, Marc Lalonde, in 1974, presented a document to his country's Parliament which came to be known as the Lalonde Report. Created with the goal of presenting a new perspective upon health and charting a path to separate health policy into manageable segments, the report was largely a response to the introduction of a prepaid health insurance scheme in Canada which required the federal government to pay for half of the costs of medical and hospital services. Costs and the corresponding public expenditures quickly increased amid evidence that the population's health status was not improving. It became clear that cancer, cardiovascular disease, respiratory illnesses, and accidents were not being prevented by a health system based upon the medical model. The final chapter of the Lalonde Report offered objectives, strategies, and 74 recommended courses of action for governments, nongovernmental organizations, and the general public. The report contains material which was revolutionary at the time it was published, but which is now widely accepted. Broad objectives proposed included reducing mental and physical health hazards for the segments of the population at high risk, and improving access to good mental and physical health care where necessary. Overall, Canadians were unsupportive of the changes to the health system implicit in the report.

Milne, a new low-frequency antigen.

A new low-incidence red cell antigen (Milne) has been detected. The antigen is inherited as an autosomal dominant and is not controlled by MNSs, Kell, Duffy, or Se. Anti-Milne is not uncommon and is often found in sera containing antibodies to other low-frequency antigens.

Foraging ecology and use of space in wild golden lion tamarins (Leontopithecus rosalia).

In this paper we describe the use of space and feeding ecology of seven groups of golden lion tamarins observed for a total of 2,164 hr in Poço das Antas Reserve, Rio de Janeiro, Brazil. Relative to habitat availability in the home ranges of these groups, lion tamarins spent more time than expected in relatively undisturbed swamp forests and less time than expected in more degraded hillside and pasture habitats. Home range area was correlated with group biomass but not group size. Golden lion tamarins fed primarily on fruits and small animal prey, but relied heavily on floral nectar during seasonal periods of relatively low fruit availability. Compared to other New World monkeys, lion tamarins used larger home range areas and exhibited longer daily path lengths than would be predicted by group biomass alone. We suggest that this pattern of foraging and use of space may be explained by the relatively greater availability of cryptic prey and their microhabitats in forests that are flooded and/or have closed canopies than in forests that are in earlier stages of succession where prey may be more susceptible to desiccation during the dry season.

The Jk(a-b-) phenotype in New Zealand Polynesians.

The Kidd locus phenotype Jk(a-b-) was detected in 0.9 percent of Polynesians living in New Zealand. Over a period of 13 years, nine examples of anti-Jk3 were detected, one of which caused a delayed hemolytic transfusion reaction. Other examples resulted in mild hemolytic disease of the newborn. The anti-Jk3 reacted as an inseparable antibody, confirmed that inheritance of the Jk(a-b-) phenotype was best explained by the presence of a silent Jk allele.