Antipeptide antibodies recognizing plasmin sensitive sites in bovine beta-casein sequence

To investigate plasmin activity in cheese, we produced antibodies to bovine beta-casein with controlled specificity, suitable as markers of the integrity of the major bonds involved in its initial breakdown. Sixteen rabbits were immunized with synthetic substitutes for six plasmin-sensitive peptides. Antisera raised to the peptides (f20-39), (f40-56), (f94-113), (f184-202), and (f193-209) recognized beta-casein in ACP-ELISA, Western-blot, and biosensor assays. Casein in vitro hydrolysis by plasmin or chymosin reduced the detection of these determinants in ACP-ELISA, in agreement with the enzymatic sensitivity of bonds included within the binding sites, or in their neighborhood. Antiserum to (f20-39) in particular allowed the specific detection of plasmin cleavage at the bond generating gamma1-CN. Antisera to C-terminus preferentially detected the cleavage by chymosin. Immunoassays using these antibodies would allow in situ monitoring of significant proteolysis events without bias originated in the secondary degradation of the released peptides.

Influence of the composition of Alpine highland pasture on the chemical, rheological and sensory properties of cheese

A study was undertaken to compare the chemical and sensory characteristics of Abondance cheeses made with milk from animals grazing areas within the same highland pasture, but with different predominant plants. Nine cheeses made during the last 3 d of three successive 7 d periods were evaluated. The animals grazed on the southern side of the highland pasture during the first period (15-21 June), on the northern side during the second period (22-29 June) and returned to the southern side for the third period (30 June-6 July). The gross composition of the cheeses did not vary between periods. 'North' cheeses contained more plasmin, gamma-casein, alpha s1-I-casein and water-soluble N than 'south' cheeses. Both sensory and instrumental measurements indicated that north cheeses were less firm, stickier and more easily fractured than south cheeses. North cheeses were also more salty, bitter and persistent. Their overall aroma was more intense and they had more intense sour, burnt, toasted, fermented vegetable and sweat aromas, but less intense toffee, exotic fruit and acid milk aromas. The texture differences noted between the cheeses from milk produced on the two areas may come from differences in primary proteolysis, partly due to different amounts of plasmin and plasminogen in milk and in cheeses. The aroma differences were related to differences in volatile compounds. Some compounds had a microbial origin, while some others may have come from the pasture.

Characterization of the heat treatment undergone by milk using two inhibition ELISAs for quantification of native and heat denatured alpha-lactalbumin

Dairy industries are interested to know the heat treatment undergone by milk for controlling the quality of drinking milks or to control their heating systems. The purpose of this work was to develop a specific and sensitive technique for classification of the heat treatment a milk has been submitted to, without disposing of the original raw milk. For this purpose, alpha-lactalbumin was chosen as a bioindicator of heat treatment, and monoclonal antibodies specific for its native or heat-denatured form were raised and used in two inhibition ELISAs. ELISA allowed differentiation among raw, pasteurized, ultrahigh-temperature-treated, and sterilized milks without even having to know the alpha-lactalbumin concentration of the original raw milk. However, this technique was more suitable for intense heat treatments such as UHT treatment and sterilization because of the heat stability of alpha-lactalbumin.

Protein identification using 20-minute Edman cycles and sequence mixture analysis

We have developed a 20-min Edman cycle and a multiple sample horizontal flow reactor for the sequence analysis of PVDF-electroblotted proteins. The 20-min cycle uses a 12-min C18 phenylthiohydantoin separation. This cycle and separation is compatible with most Applied Biosystems sequencers. Using this rapid cycle, 10 residues on six different proteins can be completed within a 24-h period. We also demonstrate the use of an algorithm that can sort mixture sequences derived from PVDF bands that contain coeluting proteins.

[Bronchial endoscopy under local anesthesia and pain in children. The value of a nitrous oxide-oxygen combination]

To evaluate the efficacy of continuous administration of 50% nitrous oxide in oxygen for reducing pain during flexible fiberoptic bronchoscopy 32 children aged 3-60 months were randomly assigned to an experimental or a control group. Indications for endoscopy included persistent atelectasis (6), wheezing (10) cystic fibrosis (2) pneumonia (11) persistent cough (3). All patients received Midazolam (0.3 mg/kg) atropine (20 mcg/kg) intra rectaly 20 minutes before the procedure. The flexible fiberoptic bronchoscope (Olympus BF3C4) was inserted transnasally through a face mask. Topical anesthesia with 1% lidocaine hydrochloride (3 mg/kg) was applied to the nose, larynx, trachea and bronchial tree over 15 minutes through the suction chanel of the bronchoscope. All patients were monitored with a pulse oximeter and a cardiac monitor. The experimental group (n = 16) received 50% nitrous oxide in oxygen prior (3 minutes) and during flexible fiberoptic bronchoscopy, the control group (n = 16) received only oxygen. We measured pain of the children by a behavioral observation scale (Children's Hospital of Eastern Ontario Pain Scale: CHEOPS) at each phase of topical anesthesia during bronchoscopy in the two groups. At the end of bronchoscopy physician's satisfaction was scored by a visual analogue scale (VAS 0-100) in which 0 corresponded to absence of satisfaction. Nitrous oxide was associated with lesser pain scores than those with oxygen. Physician significantly preferred these procedure compared with oxygen. No complication occurred during procedure. Combined with local anesthesia midazolam and atropin the administration of 50% nitrous oxide in oxygen seems a better choice for flexible fiberoptic bronchoscopy in children and should be used routinely.

-Neonatal Kasabach-Merritt syndrome healed by complete surgical excision of the angioma-

BACKGROUND

Kasabach-Merritt syndrome is an infrequent combination of a giant hemangioma and severe thrombocytopenia. This syndrome may be life-threatening. There are various but no definitive methods of treatment. We describe here a neonatal case cured by total excision of the tumor.

CASE REPORT

A boy was admitted at birth with a giant hemangioma of the back with thrombocytopenia. Tumor compression, corticosteroids, acetylsalicylic acid and ticlopidine were ineffective. Total surgical excision was performed on day 51, resulting in complete recovery.

CONCLUSION

Total surgical excision of a localized hemangioma in a non-functional area is probably the most appropriate and justified treatment for the Kasabach-Merritt syndrome.

Differential titration of plasmin and plasminogen in milk using sandwich ELISA with monoclonal antibodies

Two sandwich enzyme-linked immunosorbent assays (ELISA) have been developed for quantitation of bovine milk plasminogen and plasmin. The assays used two monoclonal antibodies, one specific for plasminogen and the other specific for plasminogen plus plasmin. Plasmin concentration was obtained by subtracting the first concentration from the second. The assays were sensitive (linear range, 5-75 ng/ml), repeatable (CV, 8 and 5% for plasmin and plasminogen titration respectively), specific (no cross reactivity with the major milk proteins) and directly applicable to skimmed milk with no particular pretreatment of the sample. However, ELISA did not permit complete titration of milk plasminogen and plasmin (only 60-90% could be quantified). This lack of accuracy was due to casein interfering with the plasmin-plasminogen titration by ELISA. Results obtained with ELISA or an enzymic technique on 20 milk samples collected from individual cows milked throughout pregnancy showed that the ELISA was particularly suitable for analysis of late lactation or mastitic milk where proteinase inhibitors interfered with enzymic quantitation.

[Management of newborn infants in maternity-neonatal intensive care units]

BACKGROUND

Although in utero transfer seems actually the safest option when risk factors are identified, specialized transport teams remain important to consider for the neonatal overall management.

SUBJECTS

From January 1988 through December 1992, 692 transports of 838 neonates were prospectively studied to determine effectiveness and safety of the Hospital Lenval's neonatal transport team.

RESULTS

Neonatal transports were required respectively for prematurity (46.4%), acute fetal distress (13.8%), respiratory distress (10.1%), intrauterine growth retardation (7.8%), multiple pregnancies (5.2%), perinatal asphyxia (3.1%) and life-threatening congenital abnormalities (2%). Pediatric assistance was unplanned in most of the cases (80%). Assistance with a pediatrician before delivery was performed more frequently (70%) for premature babies (mean gestational age 34.1 +/- 3.1 wk) delivered by cesarean section in 66.4% of the cases; in this group, delivery room resuscitation was less aggressive. Assistance was performed after delivery less frequently (30%), approximately in one-half of the cases for neonatal distress: respiratory (33.9%) or neurologic (17.1%); in this group, delivery room resuscitation was more aggressive. In transit, ventilation support via endotracheal intubation was given to 17.9% of the babies. Neither death nor heavy complication occurred during transport. On arrival in the neonatal intensive care unit, hypothermia was noted in 9.6% of the cases, hypotension in 4.3%, hypoglycemia in 13.1% and metabolic acidosis in 10.4%. In our series, the overall mortality rate was 6%, and incidence of neurologic damage 3.3%.

CONCLUSION

A skilled person in neonatal resuscitation available at every referring maternity and regional high-risk obstetric/neonatal combined centre are two recommendations which could provide improved neonatal management.

[Lethargic form of acute intestinal intussusception in an infant]

BACKGROUND

Intussusception encephalopathy, a misleading form in which neurological symptoms are obvious, is classic but rarely described.

CASE REPORT

A 21 month-old infant was admitted because he had suffered from fluctuating consciousness and apathy for a few hours. Vomiting occurred soon afterwards. Search for dehydration, meningitis, encephalitis, poisoning... was negative; the abdomen was tender leading to ultrasonography that showed a sausage-shaped tumor. The ileocolic intussusception was successfully reduced with a gas enema.

CONCLUSION

A striking degree of lethargy associated with vomiting may overshadow to a considerable extent the classical intestinal manifestations. A possible endogenous opioid poisoning by massive secretion of endorphins during pain's paroxysm is one of the hypotheses explaining this type of presentation.

Production and characterization of specific bovine plasminogen monoclonal antibodies

A collection of monoclonal antibodies was raised against bovine plasminogen by immunizing mice with purified plasminogen. More than 300 positive clones were obtained in 1 fusion experiment (1300 hybrids tested). Four types of antibodies were characterized through their relative binding to plasmin and plasminogen in ELISA. About one-third was strictly specific to plasminogen; the selectivity of this group was confirmed by immunoblots and BIA-core analysis. Cross-reactivity against horse, human, pig, sheep, rabbit, and bovine plasminogens was tested; 41% were strictly bovine specific.

[Evaluation of sport injuries in children and adolescents]

During 1992, 541 sport injuries (6.3% of the 8641 surgical emergencies) were recorded at Lenval's hospital pediatric emergency ward in Nice. There were a majority of boys (62%), and the mean age was 11.2 years. Thirty one sports were represented, mainly soccer (18.5%), bicycle (12.2%), basketball (9.4%), gymnastics (9.4%), ski (9.2%) and equitation (7.8%). Injuries occurred during competition in 12.7% of the cases, school practice in 36.3%, and free practice in 51%. Lesions concerned head and face in 15.5% of cases, the trunk in 9.2%, and limbs in 75.3% with a majority of twists and benign contusions. The hospitalisation's rate was 14.4%, and a surgical intervention with anesthesia was performed in 7.6% of cases to treat one shoulder dislocation and 42 limb fractures. Thirty percent of children were confirmed sportsmen/women, 40% of them were involved in competitive sports, the most frequently concerned sports being soccer (24.6%), basketball (18%), fighting sports (11.4%; 7.2% = judo), gymnastic (10.1%), tennis (7.9%) and equitation (6.7%). From this study most sports injuries in children appears benign even if some fractures led to hospitalisation and orthopedic surgery; this is possibly related to the quality of education and coaching, particularly during physical training at school.

Tardive dyskinesia in elderly psychiatric patients: a 5-year study

OBJECTIVE

The authors investigated the prevalence of tardive dyskinesia among elderly psychiatric patients who had never received neuroleptic medication before their first hospitalization.

METHOD

The study was performed in the geriatric psychiatry unit of a university-affiliated hospital in Canada and involved all first-admission patients admitted from September 1984 through August 1989 who had never taken neuroleptic drugs. In September and October 1989, the patients who were available for follow-up were examined and given ratings on the Abnormal Involuntary Movement Scale to establish the presence or absence of tardive dyskinesia. The patients' records were reviewed for information on age, diagnosis, duration of hospitalization, neuroleptic treatment received after admission, anticholinergic drugs received, and drug-free periods.

RESULTS

Of the 162 patients who were available and whose data were analyzed, a total of 99 had been treated with neuroleptics, and 35 (35.4%) of these were found to have tardive dyskinesia. Two of the 35 also had tardive dystonia. Significantly more patients with major depression than patients with primary degenerative dementia or delusional psychosis had tardive dyskinesia.

CONCLUSIONS

This study confirms the higher vulnerability of elderly psychiatric patients treated with neuroleptics to the development of tardive dyskinesia. The authors stress that caution is especially necessary when neuroleptics are prescribed for older patients with major affective disorders.

[Postoperative intestinal intussusception in children]

Two cases of postoperative intussusception (POI) are reported. Both children, 13 and 6 months old, had long and difficult surgery for abdominal neuroblastoma after four courses of chemotherapy. Obstruction of the small intestine occurred on the fifth postoperative day, after feeding had been started again, in the first child, and on the third day in the second one. Surgery revealed a loose ileo-ileal invagination of 10 and 15 cm respectively, which was easily reduced. The postoperative course was uneventful in both cases. Although POI is a classical complication of abdominal surgery, it is often forgotten. In the cases described, the first surgical procedure combined most causative factors for POI: young age, preoperative chemotherapy, prolonged general anaesthesia, extensive retroperitoneal dissection close to components of the neurovegetative system. The use of opioids for postoperative analgesia may be an additional risk factor, as they alter intestinal motility. Epidural analgesia with local anaesthetics should be preferred in such cases.

[Palatal groove in premature newborns]

Prolonged intubation for very low birth weight neonates induces the formation of a palatal groove. Intraoral appliances are used to prevent this complication. However, it still exists inhalation and ingestion risks when an impression is taken. Irritation of the skin of the upper lip when using a surgical tape to secure the tube is usual. This article deals with modifications brought to avoid such disadvantages.

Spontaneous hematoma of the kidney simulating a nephroblastoma. Report of two cases

The International Society of Pediatric Oncology (SIOP) 6 clinical trial for Wilms' tumor (WT) includes preoperative chemotherapy for all nonmetastatic patients. Approximately 50% of patients treated in this manner can be classed stage 1 after surgery. This strategy requires a positive diagnosis in the absence of histologic data. Diagnostic errors are very rare: Only 1.5% of the first 856 cases entered in the SIOP 6 trial were found to be benign. This article reports two very similar cases of spontaneous hematoma of the kidney that were initially misdiagnosed as hemorrhagic WT. Unusual severe acute anemia was a feature of both cases. Even the most modern state-of-the-art imaging techniques were unable to rule out the possibility of a tumor subjacent to a voluminous renal hematoma. The patients' courses during preoperative chemotherapy were of no formal diagnostic value, and the correct diagnosis was not made until surgery.

[Human collagen IV lenses and epikeratoplasy in monkeys. Study of epithelial cicatrization]

A previous study showed the good tolerance of the human type IV collagen lenses implanted by epikeratoplasty in 8 monkeys. It also showed type IV collagen is a good material for the reepithelialization. But we have been interested in the stability of the epithelial healing. The ultrastructural study found anchoring structures. However these were inconstant. So the authors try to understand better the mechanisms of this synthesis of the anchoring structures and describe the future ways of this experimental study.

Biocompatibility of human collagen type IV intracorneal implants

A new biomaterial made from human placental collagen type IV has been developed in corneal inlays for refractive keratoplasty. Eight dogs received intracorneal lenses to investigate biocompatibility. Postoperative follow-up observation of 2 years revealed that the eyes remained clear and without inflammatory reaction. Endothelial cells were unaltered. Histological and ultrastructural studies showed no signs of inflammation, ulceration, or encapsulation. No fibroblastic activity was evident at the lens stroma interface.