INSULIN ANTIBODY VARIATIONS IN RABBITS AND GUINEA PIGS AND MULTIPLE ANTIGENIC DETERMINANTS ON INSULIN

1. A method is presented for measuring the degree to which insulin antibodies in one antiserum react with an insoluble insulin complex saturated with antibodies from a different antiserum. 2. Many rabbits produce antibodies which bind to portions of the insulin molecule to which antibodies from guinea pigs or other rabbits cannot bind. 3. Occasional guinea pigs produce antibodies which bind to portions of the insulin molecule to which antibodies from rabbits or other guinea pigs cannot bind. 4. Studies with labeled antisera and repeated incubations of test antisera with antibody insulin complexes demonstrate the individual antibody variations to be due to antibodies directed to different determinants and not to dissociation of antibodies from the same determinant on the insulin molecule. 5. More than one antibody molecule can simultaneously bind to an insulin molecule. 6. Insulin has a multiplicity of antigenic determinants. 7. The relationship between antigenic determinants, insulin antibodies, and neutralization of insulin by antisera is discussed. 8. The determinants to which insulin antibodies are directed appear to be characteristic for the individual rabbit or guinea pig immunized. It is postulated therefore that genetic factors direct antibody production toward specific determinants when insulin is the antigen.

Efficacy of cardiopulmonary resuscitation performed in a dental chair

BACKGROUND

Within the dental setting, historically there has been some concern as to whether cardiopulmonary resuscitation (CPR) can be performed effectively in the dental chair. This study tested the hypothesis that there is no difference in the efficacy of CPR performed in the dental chair or on the floor.

METHODS

Four cycles of two-person CPR were performed by three health professionals on a manikin positioned alternately on the floor and in a dental chair. Ventilation was performed using a Laerdal pocket mask, without oxygen supplementation. Compression and ventilation performance was recorded using a computerized manikin skill meter.

RESULTS

Each of the participants was able to achieve a mean cardiac compression depth of between 41 and 50cm, irrespective of the CPR surface. The only statistically significant difference found in expired air resuscitation (EAR) and external cardiac compression performance was that 37 per cent of ventilations performed on the floor were deemed to be too shallow, compared to only 15 per cent in the dental chair (p=0.001).

CONCLUSIONS

It is possible for those trained in basic life support to perform CPR effectively in the dental chair. Each of the participants agreed that CPR, in particular EAR, was easier to perform when the manikin was in the dental chair compared with the floor. Dentists are encourage to regularly update their CPR knowledge and skills, including the practice of CPR in the dental chair.

Perinatal risk factors for childhood Type 1 diabetes in Western Australia--a population-based study (1980-2002)

AIMS

To investigate perinatal risk factors for childhood Type 1 diabetes in Western Australia, using a complete population-based cohort.

METHODS

Children born between 1980 and 2002 and diagnosed with Type 1 diabetes aged < 15 years (n = 940) up to 31 December 2003 were identified using a prospective population-based diabetes register with a case ascertainment rate of 99.8%. Perinatal data were obtained for all live births in Western Australia from 1980 to 2002 (n = 558 633) and record linkage performed to identify the records of cases.

RESULTS

The incidence of Type 1 diabetes increased by 13% for each 5-year increase in maternal age [adjusted incidence rate ratio (IRR) 1.13, 95% confidence interval (CI) 1.05, 1.21], by 13% for every 500-g increase in birth weight (adjusted IRR 1.13, 95% CI 1.04, 1.23). The incidence decreased with increasing birth order (adjusted IRR 0.89, 95% CI 0.82, 0.96) and increasing gestational age (adjusted IRR 0.84, 95% CI 0.77, 0.93). A higher incidence of Type 1 diabetes was associated with an urban vs. non-urban maternal address at the time of birth (adjusted IRR 1.38, 95% CI 1.18, 1.63), but no association was found with socio-economic status of the area.

CONCLUSIONS

A higher incidence of Type 1 diabetes was associated with increasing maternal age, higher birth weight, lower gestational age, lower birth order and urban place of residence at the time of birth.

Comparison of Acute Physiology and Chronic Health Evaluation (APACHE) II score with organ failure scores to predict hospital mortality

This study compared the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II score with two organ failure scores in predicting hospital mortality of critically ill patients. A total of 1311 consecutive adult patients in a tertiary 22-bed multidisciplinary intensive care unit (ICU) in Western Australia were considered. The APACHE II score had a better calibration and discrimination than the Max Sequential Organ Failure Score (Max SOFA) (area under receiver operating characteristic (ROC) curve 0.858 vs 0.829), Admission SOFA (area under ROC 0.858 vs 0.791), and the first day or cumulative 5-day Royal Perth Hospital Intensive Care Unit (RPHICU) organ failure score (area under ROC 0.858 vs 0.822 and 0.819, respectively) in predicting hospital mortality. The APACHE II score predicted hospital mortality of critically ill patients better than the SOFA and RPHICU organ failure scores in our ICU.

Technik der perkutanen SI-Verschraubung mit Unterstützung durch konventionellen C-Bogen

BACKGROUND

During percutaneous iliosacral screw fixation, fluoroscopy with a conventional C-arm X-ray unit is still the standard procedure for intraoperative orientation. Lateral sacral images in combination with the inlet and outlet view are always necessary. Nevertheless, the complex pelvic anatomy makes it difficult to prevent malpositioning of screws.

OPERATIVE TECHNIQUE

Defining the correct entry into the bone is the decisive step for ideal screw placement. The better this is defined, the larger safety margins will be concerning cortical perforation by the screws. In the lateral view, an entry ventral to the sacral canal has to be avoided as well as an entry into the cranial half of the first sacral vertebra. To improve the surgeon's three-dimensional orientation with the help of his personal experience and two-dimensional images, it is recommended to place the tip of the screws in the center of the sacrum (in AP view) whenever possible. Routinely performed postoperative CT imaging of 24 screws, consecutively implanted according to the standards described, revealed no case of malpositioning.

CONCLUSION

Standard X-ray views in combination with standardized aiming of screw entry position and final screw thread position enable the surgeon to find the "safe zone" for iliosacral screw insertion and to prevent iliosacral screw malpositioning with high accuracy.

A survey of online harassment at a university campus

This exploratory study of 339 students at the University of New Hampshire found that approximately 10% to 15% of students reported receiving repeated e-mail or Instant Messenger (I-M) messages that "threatened, insulted, or harassed," and more than half of the students received unwanted pornography. Approximately 7% of students reported online harassment to an authority. Messages originated from strangers, acquaintances, and significant others. No difference in online harassment was found based on demographic variables except sexual orientation. Sexual minority students were more likely to receive online harassment from strangers than were heterosexual students. Implications for further research and for policy/program development are discussed.

An enhanced autogene-based dual-promoter cytoplasmic expression system yields increased gene expression

The relatively low levels of transfection that can be achieved by current gene-delivery systems have limited the therapeutic utility of gene transfer. This is especially true for nonviral gene-delivery systems, where the levels of gene expression achieved are usually below the levels achieved by viral gene transfer systems. One strategy for increasing gene expression is to design a cytoplasmic expression system that does not require nuclear delivery for gene expression to occur. This can be achieved through the use of an autocatalytic cytoplasmic expression system using phage RNA polymerases. Here we describe cytoplasmic expression systems that yield increased levels of gene expression following in vitro transfection. We demonstrate direct evidence for an exponential, autocatalytic increase in gene expression using autogenes, as well as levels of reporter gene expression that are 20-fold higher than standard CMV-based nuclear expression systems. The development of a high-efficiency plasmid-based expression system could significantly improve the gene expression properties of nonviral gene-delivery systems, thereby increasing their clinical utility.

The influence of age, gender and ethnicity on cadaveric organ recovery rate

In view of the influence of donor factors such as age on graft outcome and the performance standards that measure OPO productivity by the number of organs recovered and transplanted, it is important to understand the relationship of certain donor factors on organ recovery for transplantation from cadaveric donors. We examined the influence of donor age, gender and ethnicity on the number and type of transplanted organs recovered from 598 consecutive cadaveric donors in our OPO between 1994 and July 1999. The highest number of organs/donor ocurs in the 11-20 donor age range and declines significantly with each age range. The type of organ recovered is also influenced by age, but the least effect is on liver recovery. No difference was seen in the number of organs recovered/donor by race. When the data were re-analyzed with regard to renal and extra-renal organs transplanted/million donor population, 78% of the kidneys (n=781/1006) were from the 11-50 age range and 81% of the extra-renal organs (n=822/1,192) were from that age range. Stepwise regression yielded a model where donor age significantly influenced (P=0.001) the number of organs recovered. Finally, the incidence of recovered and transplanted organs was significantly higher in males compared with females for hearts [51% (187/360) vs. 40% (86/214); P<0.006] and pancreata [18% (66/360) vs. 11% (24/214); P<0.02]. The number of organs recovered and transplanted from cadaveric organ donors is influenced predominantly by the age of the donor, with the exception being liver donors. Increasing organ recovery and transplantation of organs from donors from the two age extremes results in less gain in the number of organs/million population than recovery from the 11-50 age range.

Dynamic mimicry in an Indo-Malayan octopus

During research dives in Indonesia (Sulawesi and Bali), we filmed a distinctive long-armed octopus, which is new to science. Diving over 24 h periods revealed that the 'mimic octopus' emerges during daylight hours to forage on sand substrates in full view of pelagic fish predators. We observed nine individuals of this species displaying a repertoire of postures and body patterns, several of which are clearly impersonations of venomous animals co-occurring in this habitat. This 'dynamic mimicry' avoids the genetic constraints that may limit the diversity of genetically polymorphic mimics but has the same effect of decreasing the frequency with which predators encounter particular mimics. Additionally, our observations suggest that the octopus makes decisions about the most appropriate form of mimicry to use, allowing it to enhance further the benefits of mimicking toxic models by employing mimicry according to the nature of perceived threats.

A series of quinoline analogues as potent inhibitors of C. albicans prolyl tRNA synthetase

A series of quinoline inhibitors of C. albicans prolyl tRNA synthetase was identified. The most potent analogue, 2-(4-bromo-phenyl)-6-chloro-8-methyl-4-quinolinecarboxylic acid, showed IC50 = 5 nM (Ca. ProRS) with high selectivity over the human enzyme.

Lack of relationship between functional ability and skin score in patients with systemic sclerosis

OBJECTIVE

To examine the hypothesis that functional ability is related to skin score in patients with systemic sclerosis (SSc).

METHODS

In 140 patients with SSc attending clinics in the northwestern region of England, functional ability (measured using a recently developed 11 item functional questionnaire) was correlated with skin score (measured using a modified Rodnan technique--17 sites, maximum score 3 for each site).

RESULTS

The median functional score was 6 (range 0-31) and the median skin score 7 (range 0-37). There was no correlation between functional score and total skin score (rS = 0.11, p = 0.19, Spearman). Because most of the questions of the functional score related to upper limb function, separate analyses were undertaken restricting consideration of skin involvement to (1) upper limbs only and (2) digital skin only, versus the overall functional score. Again, no evidence of an association was observed.

CONCLUSION

Functional ability in this broad group of patients with SSc cannot be predicted from the skin score. Although skin score is useful prognostically, it is not a major determinant of a patient's ability to perform activities of everyday living.

Revision of the Octopus horridus species-group, including erection of a new subgenus and description of two member species from the Great Barrier Reef, Australia

The tropical Indo-West Pacific region contains a distinctive group of small to moderate-sized octopuses referred to in the past as the Octopus horridus species-group. Member species are found primarily on intertidal reef flats. They possess small bodies, long arms and complex skin sculpture and body patterns enabling excellent camouflage. When attacked, these octopuses are capable of autotomising their arms at the base: the writhing severed arm acting as a decoy to predators and aiding escape. Lost arms regenerate within 2–3 months. Attributes of this group of octopuses are described and the subgenus Abdopus, subgen. nov. is here coined to define this group. Historically, many members of this subgenus have been incorrectly identified as Octopus horridus, a distinct large-egg species known only from the Red Sea and the northwest Indian Ocean. Seven species are here recognised as belonging in Abdopus, subgen. nov. Two member species from Great Barrier Reef waters (Octopus aculeatus d’Orbigny, 1834 and Octopus capricornicus, sp. nov.) are described. A number of additional, as yet undescribed, species occur throughout the Indo-West Pacific region. Certain earlier works have linked other octopus genera and species with members of this subgenus on the grounds of long arms and arm autotomy. Significant differences occur in the morphologies of these taxa and the nature of the arm autotomy processes. It is proposed that these groups have evolved independently and that arm autotomy has arisen more than once amongst the octopuses. The restriction of the subgenus Abdopus to the tropical Indo-West Pacific region suggests relatively recent origins and radiation.

Cardiac troponin I in pre-eclampsia and gestational hypertension

OBJECTIVE

To investigate serum cardiac troponin I, a sensitive marker of cardiac myocyte damage, in normal pregnancy and pregnancies complicated by hypertension with and without significant proteinuria.

DESIGN

Prospective cross sectional study.

SETTING

University hospital delivery suite.

SAMPLE

Serum samples obtained from women in normal pregnancy and in pregnancies complicated by hypertension with and without significant proteinuria.

METHOD

Women with hypertension in pregnancy (at least two readings of systolic blood pressure > 140 mmHg and diastolic blood pressure > 90 mmHg) (n = 26) and normotensive women (n = 43) were included in the study. Serum cardiac troponin I was measured using Beckman Access immunoassay.

MAIN OUTCOME MEASURE

Serum cardiac troponin I level in the pregnancies complicated by hypertension (with and without significant proteinuria) compared with the levels measured in normotensive women.

RESULTS

The median serum cardiac troponin I level in pregnancies complicated by hypertension was 0.118 ng/mL (n = 26) which was significantly greater than that measured in samples obtained from normotensive women in pregnancy (0.03 ng/mL; n = 43) (P < 0.0001). There were higher median serum cardiac troponin I levels in hypertensive women with significant proteinuria (0.155 ng/mL; n = 6), compared with those without proteinuria (0.089 ng/mL; n = 20; P = 0.03).

CONCLUSION

Serum cardiac troponin I is elevated in women with hypertensive disorders of pregnancy indicating some degree of cardiac myofibrillary damage in these disorders.