Studies of bone density, quantitative ultrasound, and vertebral fractures in relation to collagen type I alpha 1 alleles in elderly women.

Previous studies have demonstrated that an Sp1 binding site polymorphism in the collagen type I gene (COLIA1) is related to reduced bone mineral density (BMD) and osteoporotic fractures in certain populations, particularly in the elderly. We have examined the relationship among these COLIA1 Sp1 alleles, BMD, quantitative ultrasound properties of bone, and fractures in a population-based cohort of elderly women from the UK. The study group comprised 314 women aged 75 years and over who agreed to participate in a clinical study of bisphosphonate therapy in preventing bone loss at the hip. Women were enrolled regardless of the presence or absence of osteoporosis, but those with other diseases that might affect skeletal metabolism were excluded. The genotype distribution for the Sp1 polymorphism was in Hardy-Weinberg equilibrium (SS - 78%; Ss - 20%; ss - 2%) but the proportion of individuals who carried the "s" allele (22%) was significantly lower than previously observed in another study of the UK population (37.1%) (P < 0.001). There were no significant associations between COLIA1 genotypes and metacarpal cortical index, BMD of the forearm, tibial SOS, calcaneal SOS, or calcaneal BUA. While there was a trend towards lower BMD values at the hip in patients with Ss and ss genotypes, this was not statistically significant (SS = 0.721 +/- 0.14; Ss = 0.704 +/- 0.13; ss = 0.683 +/- 0.20 P = 0.6). Prevalent vertebral fractures occurred in 22% of subjects and prior fractures of the wrist, ankle, and hip were reported by 20%, but there was no significant difference in COLIA1 genotype distribution between fracture patients and controls. We conclude that COLIA1 Sp1 alleles are not significantly associated with BMD, ultrasound properties of bone, or fractures in this population-based sample of elderly women.

Dermatophagoides farinae allergen levels from two different sources within the same home: evaluation of two different collection techniques.

The allergens produced by the dust mites of the Dermatophagoides genus are now recognized as one of the major allergens in house dust. Quantification of those allergens helps to evaluate the effectiveness of avoidance measures and specific treatments aimed at the reduction of the mites and their allergens. The present study was undertaken to compare the level of D. farinae allergen collected by a standard vacuum cleaner with a disposable bag and the level of allergen collected by a hand-held vacuum equipped with a special filter. Samples were obtained from the main living area of 18 homes of patients allergic to D. farinae. Using a hand-held vacuum especially equipped with a removable micropore filter, a 2-m2 area of carpet was vacuumed for two minutes and an identical sample was collected from the major upholstered piece of furniture in the room. A third sample was obtained with an upright vacuum fitted with a clean disposable bag. The dust collected was extracted in phosphate buffered saline and resultant extracts were assayed for D. farinae allergen content by microtiter plate RAST inhibition assay. Results from these assays showed a large interhome variability regardless of sampling technique, but intrahome sampling showed remarkable consistency. A linear regression analysis demonstrated all of the comparisons correlated at a probability level of P less than .05. We conclude that dust mite allergen levels collected in a disposable bag vacuum cleaner are reliable indicators of the level of house dust mites present in the homes of patients.

House dust mites in the West Indies.

The purpose of this study was to determine the role of the house dust mite. Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), in allergic diseases on the island of St. Lucia. Dust samples were taken from living quarters of patients and hospital volunteers. The level of Df antigen in these living quarters was measured by RAST inhibition. All samples showed Df antigen within a large range of values. Prick tests were done to house dust mite and molds on 91 patients with suspected allergic disease with 63 (69%) reacting to at least one antigen. Of these, 56 (88.9%) reacted to one or both mites. House dust mite is a major allergen in St. Lucia.

Evaluation of multi-allergen dipstick screening test.

In order to determine the diagnostic performance of the Quidel Allergen Screen (QAS), 43 patients characterized by standard skin prick test and intradermal testing for atopic sensitivity were evaluated, in parallel, using Phadebas RAST and QAS to detect the presence of serum IgE. The Quidel Allergen Screen and RAST were compared with the investigator's clinical assessment. The differences between QAS and RAST are not statistically significant. The QAS appears to be equal to the Phadebas RAST in sensitivity and specificity and thus offers a rapid, easily interpreted in vitro method for the detection of specific serum IgE.

Pigmented lesions of the oral cavity.

The factors that produce dark pigmentation of the oral soft tissues are described. Examples are given of aberrations of the melanin-forming cells in the oral cavity and a new case of oral blue nevus is added to the literature. A unique case of localized melanosis of the tongue is described clinically and histopathologically.

Peripheral facial nerve paralysis of dental origin.

The aetiology, diagnosis and treatment of peripheral facial nerve palsy are discussed. Four cases of facial nerve palsy following dental procedures are reported. Following a revision of the world literature during the last 23 years, the 25 cases of facial nerve palsy documented are analysed and divided into four groups on the basis of aetiology, speed of onset and recovery and modes of treatment suggested.

Immunofluorescence identification of Thermopolyspora polyspora, the causative agent of farmer's lung.

Farmer's lung is a serious disabling pulmonary disease found in agricultural workers. The disease is believed to be a hypersensitivity to the thermophilic actinomycetes, principally Thermopolyspora polyspora. This organism is difficult to stain with the usual bacteriological stains and thus far has not been demonstrated in the lung tissue by microscopic methods. In this paper, it is demonstrated that the fluorescent-antibody technique is a simple method for the positive identification of T. polyspora. The technique can also be used as a rapid screening test for the detection of antibodies to T. polyspora in the patient's serum. In addition, it opens up the possibility of the identification of T. polyspora in the lung tissue of patients with farmer's lung and makes available a means for the study of the immunological reaction in the lung parenchyma. No false positive or cross-reactions with Thermoactinomyces vulgaris or Streptomyces griseus could be demonstrated.