Efficacy of amitraz applied to white-tailed deer by the '4-poster' topical treatment device in controlling free-living lone star ticks (Acari: Ixodidae)

White-tailed deer treated themselves with a commercial pour-on acaricide formulation containing 2% amitraz as they fed from an ARS-patented '4-poster' topical treatment device. Whole kernel corn attracted deer to a single device placed in each of two deer-fenced pastures. In the treatment pasture, the rollers of the treatment device were charged with the acaricide, whereas the rollers of the device in the other pasture remained untreated. Deer were allowed to use the '4-posters' during periods of tick activity beginning in early to midspring and lasting through late summer to early fall for three consecutive years. Pretreatment sampling of adults and nymphs with dry-ice traps and larval masses with flip cloths showed no significant differences in population indices between the two pastures; however, after the third year of treatment, control of nymphal and adult ticks in the treated pasture was 91.9 and 93.7%, respectively, when compared with the untreated pasture. Control of larval masses increased from 68.4% in year 1 to 96.4% in year 2, but declined to 88.0% in year 3, probably because of the presence of feral hogs. This study demonstrated that application of amitraz to white-tailed deer through free-choice interaction with a '4-poster' device significantly reduced the abundance of free-living lone star ticks in a deer-fenced experimental pasture. Moreover, the yearly pattern of incremental increases in control and the final percentage control values for all three parasitic life stages in this topical application study were similar in magnitude to that observed in a previously conducted study in which the systemic acaricide ivermectin was used to reduce populations of free-living ticks by controlling ticks on deer.

Urinary incontinence: a classification system and treatment protocols for the primary care provider

PURPOSE

To provide nurse practitioners (NPs) with an objective system for classification of urinary incontinence and protocols for treating the condition in the primary care setting.

DATA SOURCE

Clinical practice guidelines and the author's clinical experience.

CONCLUSIONS

By using tables of classifications of urinary incontinence, management strategies, and protocols, NPs can successfully manage mild urinary incontinence in primary care settings in a cost-effective manner.

IMPLICATIONS FOR PRACTICE

A thorough history and objective classification of the severity of incontinence provides the framework for treating urinary incontinence in a methodical and effective manner.

2,2'-Anhydro-4'-thionucleosides: precursors for 2'-azido- and 2'-chloro-4'-thionucleosides and for a novel thiolane to thietane rearrangement

2,2'-Anhydro-4'-thio-beta- and alpha-nucleosides 9 and 10 have been prepared by an in situ 4-thio-1,2-glycal addition route. They undergo ring-opening by azide or chloride ion to give, after deprotection, the 2'-substituted-4'-thionucleosides 13 and 14, whereas reactions with cyanide or fluoride sources lead to the unsaturated nucleosides 17 or 18, depending upon conditions. An unexpected and clean rearrangement to the thietane 23 occurs on treatment of uracil derivative 20 with DAST.

Angiotensin II type 1 receptor gene polymorphism and the response to hyperglycemia in early type 1 diabetes

Recent studies suggest that there is an association between the A1166-->C polymorphism of the angiotensin II type 1 receptor (AGT1R), glycemic control, and the risk of diabetic nephropathy in subjects with type 1 diabetes. Because hypertension and renal hemodynamic function are also related to the risk of diabetic nephropathy and because hyperglycemia can activate the renin angiotensin system, we sought to determine if there is an association between the AGT1R polymorphism, baseline renal and peripheral hemodynamic function, and pressor response to high glucose in subjects with early uncomplicated type 1 diabetes. There were 39 diabetic subjects genotyped for the AGT1R polymorphism by polymerase chain reaction and segregated into 2 groups: those with and those without the C1166 allele (AA and AC/CC). The average age was 27 +/- 1 years, and the mean duration of diabetes was 3.5 +/- 0.6 years. HbA(1c) values were <10% in all subjects and were similar in the 2 groups (8.2 +/- 0.3 vs. 9.1 +/- 0.4%). After a 7-day controlled diet (150 mmol sodium, 1.5-2.0 g x kg(-1) x day(-1) protein), renal hemodynamic function was assessed by inulin and para-aminohippurate clearance during clamped euglycemic conditions (4-6 mmol/l). Mean values for glomerular filtration rates did not differ between groups during euglycemia. In contrast, mean values for renal plasma flow and renal blood flow were significantly greater in the AC/CC group compared with the AA group. Values for mean arterial pressure were similar in the 2 groups, whereas renal vascular resistance was significantly reduced in the AC/CC group. In 20 subjects (10 from each genotype subgroup), hemodynamic function was assessed on a second occasion during controlled clamped hyperglycemia (9-11 mmol/l) after a similar preparatory period. In response to high glucose, plasma renin activity increased in both genotype groups to the same extent, but a pressor response was noted only in subjects with the C1166 allele. Mean arterial pressure increased significantly in the AC/CC subgroup and remained unchanged in the AA subgroup. We conclude that there is an association between the AGT1R A1166-->C polymorphism and renal hemodynamic function in early type 1 diabetes. But more importantly, the pressor response to hyperglycemia is augmented in those diabetic patients with the C1166 allele and may represent a factor that predisposes them to renal injury during periods of inadequate glucose control.

Direct quantification of AD-36 adenovirus DNA by capillary electrophoresis with laser-induced fluorescence

An adenovirus, AD-36, has been linked to human adiposity and a sensitive and reliable quantitative method is required to assess AD-36 viral loads. This report describes direct detection of AD-36 viral DNA, which is the first method to quantitate DNA without amplification. Total genomic DNA is hybridized with an AD-36 specific fluorescently labeled probe and analyzed by capillary electrophoresis with laser-induced fluorescence. The minimum detectable quantity is 10.3 ng/ml, corresponding to 282 copies of AD-36 with a precision of 1-6%. These results indicate that direct detection with capillary electrophoresis with laser-induced fluorescence (CE-LIF) is a reliable and sensitive method for quantifying AD-36 viral DNA.

The '4-poster' passive topical treatment device to apply acaricide for controlling ticks (Acari: Ixodidae) feeding on white-tailed deer

A '4-poster' device that attracts white-tailed deer to a bait source, and as they feed, allows a self-application of a pesticide to the head, ears, and neck to control ticks was designed, constructed, and tested. The device consists of a central bin containing bait to attract deer and two feeding and application stations. These stations each have one bait port and two vertical pesticide-impregnated applicator rollers. This design allows unrestricted vertical retraction of the head to minimize injury to the deer or damage to the posts supporting the pesticide application rollers. Observations using deer demonstrated ready acceptance and repeated use by both antlered and antlerless deer. Results of an initial trial indicate that control values for lone star ticks, Amblyomma americanum (L.), exceeded 92-97% on deer that used the device regularly.

Efficacy of hyaluronic acid/nonsteroidal anti-inflammatory drug systems in preventing postsurgical tendon adhesions

Tendon adhesion is acknowledged to be a function of both an overwhelming inflammatory response at the surgical site and the loss of physical separation that is normally present between the tendons and the synovial sheath. Adhesions bind the flexor tendons to each other and to surrounding structures, interfering with their normal gliding function. The clinical result of adhesion formation following flexor tendon surgery is poor digital function. This study investigated the effect of intraoperative treatments of high viscosity absorbable gels made of various combinations of hyaluronic acid and nonsteroidal anti-inflammatory drugs, on adhesion formation in a leghorn chicken flexor tendon model. Forty-eight mature, white leghorn chickens were used to verify the surgical model and to test five different gel treatments. The gels were formed from: 2% sodium hyaluronate in phosphate buffered saline alone or combined with 1 mg/mL tolmetin sodium; 1 mg/mL naproxen sodium; 0.216 g/mL calcium acetate; or 0.216 g/mL calcium acetate plus 1 mg/mL naproxen sodium. The gels were applied by injecting 0.2 mL of the specified composition into the intrasheath space near the conclusion of the surgical procedure. Gross and histological evaluations were conducted to analyze the efficacy. All of the treatments significant reduced the extent and severity of postsurgical tendon adhesion in this animal model as compared with the control (no gel treatment) (p < 0.05). The combination of naproxen sodium and calcium acetate in a high viscosity sodium hyaluronate carrier was the most effective composition. The combination of a high viscosity gel and nonsteroidal anti-inflammatory drugs appears to maintain the natural separation between the tendons and their sheaths and decrease the tissue inflammatory response through mediating two of the major stimuli in adhesion formation.

Transient mediastinal enlargement: an unusual computed tomographic manifestation of pulmonary venous hypertension and congestive heart failure

We describe a case of diffuse superior and middle mediastinal enlargement of soft tissue attenuation noted on helical computed tomography (CT) of a patient with clinical and radiographic findings of congestive heart failure (CHF). Upon treatment and improvement of his pulmonary venous hypertension, a repeat CT scan revealed resolution of the mediastinal abnormalities. We, therefore, advocate a search for primary CT signs of CHF in patients with findings of widespread mediastinal distension. If present, repeat CT scanning after resolution of the cardiac condition should be performed before further intervention for the mediastinal abnormality is attempted.

The impact of biotechnology on the chemical industry in the 21st century

Although the overall size of the industrial chemicals business is US$1.4 trillion worldwide, growth has slowed in some market segments. In order to reestablish and sustain growth, materials with higher information content and improved economics based on renewable resources will be required. These challenges have motivated the pursuit of biotechnology by several traditional chemical companies, such as DuPont, Dow, BASF and Monsanto. Even though each company might differ in their strategic approach, their common goal is the same: to create high-value materials using biotechnology.

A comparison of efficacy of sargramostim (yeast-derived RhuGM-CSF) and filgrastim (bacteria-derived RhuG-CSF) in the therapeutic setting of chemotherapy-induced myelosuppression

A randomized, double-blind, multicenter study in 181 afebrile cancer patients with ANC levels < 500/microL receiving myelosuppressive chemotherapy was undertaken to compare sargramostim (yeast-derived recombinant human granulocyte-macrophage colony-stimulating factor, RhuGM-CSF) and filgrastim (bacteria-derived recombinant human granulocyte colony-stimulating factor, RhuG-CSF) in the treatment of chemotherapy-induced myelosuppression. Patients received daily subcutaneous (SC) injections of either agent until ANC levels reached at least 1500/microL. There was no statistical difference between treatment groups in the mean number of days to reach an ANC of 500/microL, but the mean number of days to reach ANC levels of 1000/microL and 1500/microL was approximately one day less in patients receiving filgrastim. Fewer patients in the sargramostim arm were hospitalized, and they had a shorter mean length of hospitalization, mean duration of fever, and mean duration of i.v. antibiotic therapy compared with patients who received filgrastim. Both growth factors were well tolerated. No patient was readmitted to the hospital after growth factor was discontinued. Sargramostim and filgrastim have comparable efficacy and tolerability in the treatment of standard-dose chemotherapy-induced myelosuppression in community practice.

Human papillomavirus types 16 E6 and E7 contribute differently to carcinogenesis

High-risk human papillomaviruses (HPVs) are etiologically implicated in human cervical cancer. Two viral genes, E6 and E7, are commonly found expressed in these cancer cells. We have previously shown that mice transgenic for the HPV-16 E6 gene or E7 gene, in which the E6 or E7 was expressed in the basal layer of epithelia, developed skin tumors. The spectrum of tumors derived from E6 and E7 mice differed, however; although most tumors derived from the E7-transgenic mice were benign, the majority of the tumors from the E6-transgenic mice were malignant. These findings led us to hypothesize that E6 and E7 play different roles in carcinogenesis. To assess at what stages in carcinogenesis E6 and E7 act, we treated the skin of K14E6- and K14E7-transgenic mice with chemical carcinogens known to contribute to distinct stages in carcinogenesis. Both E6 and E7 were found to synergize with chemical carcinogens in causing tumor formation. E6 was found to act weakly at the promotion stage of carcinogenesis in the formation of benign tumors but strongly at the progression stage which involves the malignant conversion of benign tumors. In contrast, E7 primarily affected the promotion stage of carcinogenesis. These results provide direct evidence that E6 and E7 contribute differently to carcinogenesis; E7 promotes the formation of benign tumors, and E6 acts primarily to accelerate progression of these benign tumors to the malignant stage. Consistent with this model, we found E6 and E7 to cooperate in inducing tumor formation in mice expressing both oncogenes.

Granular cell tumor of the breast: definitive diagnosis by sonographically guided percutaneous biopsy

Granular cell tumor is a rare, benign breast neoplasm that may mimic malignancy both clinically and radiologically. We present 2 cases in which granular cell tumor was initially diagnosed by sonographically guided percutaneous biopsies. Sonographic guidance confirmed needle placement during multiple passes and thereby decreased the likelihood of sampling error. A diagnosis of granular cell tumor prior to definitive resection enables optimal therapeutic planning and allows radical surgery to be avoided.

Angiotensin II type 1 receptor gene polymorphism predicts response to losartan and angiotensin II

Angiotensin II type 1 receptor gene polymorphism predicts response to losartan and angiotensin II.

BACKGROUND

Most of the known actions of angiotensin II (Ang II) are mediated by the Ang II type 1 receptor (AGT1R). A noncoding polymorphism of the AGT1R gene has been described in which there is either an adenine (A) or cytosine (C) base at position 1166. The functional significance of this polymorphism is unknown, prompting us to examine the relationship between this polymorphism and the systemic and renal responses to AGT1R blockade and subpressor Ang II infusion.

METHODS

Sixty-six healthy Caucasian men and women, genotyped for the AGT1R polymorphism by polymerase chain reaction, were chosen to form two homogeneous groups: AA and AC/CC. Renal hemodynamic function was assessed with inulin and para-aminohippurate clearance before and after AGT1R receptor blockade with losartan and Ang II infusion.

RESULTS

The mean values at baseline for glomerular filtration rate (GFR), renal plasma flow (ERPF), and renal blood flow (RBF) were significantly lower in the AC/CC group compared with the AA group. Losartan increased the GFR and decreased the mean arterial pressure (MAP) in the AC/CC group, but did not influence these parameters in the AA group. The aldosterone responses to losartan were blunted in the AA subgroup. During Ang II infusion, AC/CC subjects maintained GFR despite equivalent declines in RBF, suggesting an enhanced efferent arteriolar constrictive response.

CONCLUSIONS

Taken together, these results suggest that there is a relationship between the AGT1R A1166-->C polymorphism and the humoral and renal hemodynamic responses to AGT1R blockade and to Ang II infusion in the sodium-replete state, and that the C allele is associated with enhanced intrarenal and peripheral Ang II activity. Further studies are required to determine the genetic locus for this effect.

Control of Boophilus annulatus (Acari: Ixodidae) on cattle using injectable microspheres containing ivermectin

The efficacy of an injectable microsphere formulation of ivermectin for control of the cattle tick, Boophilus annulatus (Say), was tested on 2 groups of 6 Hereford heifers held on separate 7-ha, tick-infested, buffel grass pastures. Cattle in one pasture were injected subcutaneously in the neck with a controlled-release microsphere formulation of ivermectin at the rate of 2.4 mg AI/kg body weight; the other group was injected with carrier only. Beginning 4 wk after injection and continuing throughout the remainder of the test (16 wk), no engorged ticks (> or = 5.5 mm) were found on any of the treated cattle, whereas large numbers of engorged ticks were found on the untreated controls. During this period, a few ticks were recovered from untreated sentinel animals placed in the treatment pasture during 7-8 wk after treatment, but none were recovered from animals exposed from 11-12 wk or 14-15 wk. Large numbers of B. annulatus ticks were found on untreated sentinel cattle placed in the control pasture during these same periods. Although the cattle, pastures, and tick habitat were approximately equal, the treated cattle gained an average of 77 kg compared with an average of 42 kg for the control group. This technology offers a possible alternative to the current official program of dipping and vacating pastures for eradication of Boophilus sp. infestations from the quarantine zone in southern Texas. Larger scale testing is needed to determine the potential of the injectable microsphere formulation and to optimize its use in eradication or control strategies.

Effect of adrenocorticotrophic hormone on sodium appetite in mice

A main vector of the effects of stress is secretion of corticotrophin releasing factor (CRF), adrenocorticotrophin (ACTH), and adrenal steroids. Systemic administration of ACTH (2.8 microgram/day sc) for 7 days in BALB/c mice caused a very large increase of voluntary intake of 0.3 M NaCl equivalent to turnover of total body sodium content each day. Intracerebroventricular infusion of ACTH (20 ng/day) had no effect. Intracerebroventricular infusion of ovine CRF (10 ng/h for 7 days) caused an increase of sodium intake. The large sodium appetite-stimulating effect of systemic ACTH was not influenced by concurrent systemic infusion of captopril (2 mg/day). Induction of stress by immobilization of mice on a running wheel caused an increase in Na appetite associated with a 50% decrease of thymus weight, indicative of corticosteroid effects. The present data suggest that stress and the hormone cascade initiated by stress evoke a large sodium appetite in mice, which may be an important survival mechanism in environmental conditions causing stress.

The northern exposure sign: a newly described finding in sigmoid volvulus

OBJECTIVE

Previous studies of sigmoid volvulus have focused on the migration and dilatation of the sigmoid with respect to both fixed and mobile landmarks in the abdomen. None has specifically referred to the relationship of this colonic segment to the more proximal large intestine. We analyzed findings on abdominal radiographs, all of which had been obtained with the patient supine, of sigmoid volvulus, with particular attention to the juxtaposition of the sigmoid colon with the transverse colon.

MATERIALS AND METHODS

The abdominal radiographs of 30 patients with clinically confirmed sigmoid volvulus were obtained from the teaching files of four hospitals and were retrospectively reviewed. These radiographs were compared with abdominal radiographs of 28 individuals, each of whom had a dilated colon but not sigmoid volvulus. All radiographs had been obtained with the patient in the supine position.

RESULTS

The transverse colon was identified in 26 of the 30 patients with sigmoid volvulus. In each of these 26 patients, the sigmoid colon was cephalad to the transverse colon. Of the patients in the control group, the transverse colon was identified in 24 of the 28 patients. In none of these control group patients did the sigmoid colon extend rostral to the transverse colon. Thus, this sign had a sensitivity of 86% and a specificity of 100%.

CONCLUSION

A dilated sigmoid colon that ascends cephalad to the transverse colon is a newly described and accurate finding of sigmoid volvulus on abdominal radiographs obtained with the patient supine.

Impact of hyperglycemia on the renin angiotensin system in early human type 1 diabetes mellitus

It has been demonstrated previously that moderate hyperglycemia without glucosuria can increase plasma renin activity and mean arterial pressure in young healthy males with early uncomplicated type 1 diabetes mellitus. This study was conducted to extend these observations by testing the hypothesis that mild to moderate hyperglycemia can affect renal function by increasing renin angiotensin system (RAS) activity in diabetic humans. The study included 10 men and women with early, uncomplicated type 1 diabetes (duration <5 yr), all ingesting a controlled sodium and protein diet. They were studied on four separate occasions, during a subdepressor dose of the angiotensin II (AngII) receptor blocker losartan, and during graded AngII infusion, 1.5 and 2.5 ng/kg per min, while euglycemic (blood glucose 4 to 6 mmol/L) and again while hyperglycemic without glucosuria (blood glucose 9 to 11 mmol/L), according to a randomized crossover design. Outcome measures included mean arterial pressure (MAP), GFR, effective renal plasma flow (ERPF), renal vascular resistance (RVR), filtration fraction (FF), and urine sodium excretion (UNaV) at baseline and in response to the above maneuvers. During hyperglycemic conditions, MAP was significantly higher compared with euglycemia, as were RVR and FF. After the administration of losartan, a significant renal and peripheral depressor effect was noted, with decreases in MAP, RVR, and FF, whereas during euglycemia the responses to losartan were minimal. AngII infusion resulted in elevations in MAP, RVR, and FF and a decline in UNaV during both glycemic phases, but the responses during hyperglycemia, most significantly at the 1.5 ng/kg per min infusion rate, were blunted. These data support the hypothesis that hyperglycemia affects renal function by activating the RAS. The mechanism remains obscure, but these contrasting responses may provide a link between the observations that maintenance of euglycemia and blockade of the RAS prevent or delay diabetic kidney disease, and furthermore, may clarify the mechanism whereby high glucose promotes renal disease progression in diabetes.

New studies on trans-anethole oxide and trans-asarone oxide

The widespread use of naturally occurring alkenylbenzenes as flavoring and fragrance agents has led to a long-standing interest in their toxicity and carcinogenicity. Among them several allyl- and propenylbenzenes have been found to be mutagenic and carcinogenic. It has been shown that the carcinogenicity of several allylbenzenes can be related to the formation of electrophilic sulfuric acid esters following 1'-hydroxylation. Unlike the allylbenzenes, the mechanisms of carcinogenesis of propenylbenzenes such as anethole and asarone are not clear. It has been reported that one of the main metabolic pathways of trans-anethole is the epoxidation of the side chain 1,2-double bond, which was responsible for cytotoxicity but not for genotoxicity. However, we report here that synthetic trans-anethole oxide prepared from trans-anethole and dimethyldioxirane is not only mutagenic for Salmonella tester strains but is also carcinogenic in the induction of hepatomas in B6C3F1 mice and skin papillomas in CD-1 mice. Synthetic trans-asarone oxide was also carcinogenic in the induction of hepatomas as well as mutagenic for Salmonella strains. Further studies are needed on these side chain oxides of trans-anethole and trans-asarone as possible metabolites in the toxicity, mutagenicity and carcinogenicity of these and other propenylbenzenes.

Waxing and waning gynecomastia: an indication of noncompliant use of prescribed medication

We present two cases of recurrent gynecomastia in men enrolled in a placebo-controlled trial evaluating the efficacy of finasteride in treating benign prostatic hyperplasia. When the pharmacologic records were examined, it was apparent that the breast tissue hyperplasia diminished when the patients become noncompliant with their study medication and then resumed therapy. Because of the difficulty in obtaining accurate data on an individual's ability to maintain a consistent pharmacologic regimen, we believe that observing such "waxing and waning gynecomastia" may provide the physician with a clue regarding a patient's actual compliance with certain medications.

Chronic ethanol consumption impairs receptor-mediated endocytosis of formaldehyde-treated albumin by isolated rat liver endothelial cells

Receptor-mediated endocytosis (RME) by a scavenger receptor on sinusoidal liver endothelial cells (LECs) for formaldehyde-treated bovine serum albumin (f-Alb) has previously been shown to be impaired following chronic ethanol consumption. These studies were initially performed by in situ perfusion, making it difficult to determine the point in the process at which RME is affected. Therefore, it was the purpose of this study to use isolated LECs to begin elucidating at what point in the process chronic ethanol consumption affects RME. Initial studies showed that degradation at the single-cell level were similarly decreased at levels that had been observed for in situ studies, suggesting that the ethanol effects can be repeated using isolated LECs, making them useful for in vitro studies. Binding studies with 125I-formaldehyde-treated bovine serum albumin (125I-f-Alb) demonstrated there was a slight, but significantly different, decrease in binding by LECs from ethanol-fed rats when compared with pair-fed or chow-fed rats. However, the affinity of these receptors was not different between these groups. In contrast, a defect in the initial stages of receptor-ligand internalization was indicated as less surface-bound ligand was internalized and subsequently degraded in cells from the ethanol-treated animals as compared with controls. Additionally, once the data were adjusted for the amount of ligand internalized, the degradation of the internalized ligand was only slightly impaired. These results indicate that chronic ethanol feeding impairs the process of RME by the liver; the major cause of this impairment appears to be caused by a decreased ability of these cells to internalize all of the surface-bound ligand, with a minimal defect in postinternalization events.

Prenatal binge-like alcohol exposure in the rat results in region-specific deficits in brain growth

Children of women who abuse alcohol during pregnancy may be affected by varying degrees of neurological abnormality, even if they are not diagnosed with Fetal Alcohol Syndrome. The extent of the behavioral deficits of the affected offspring may be a function of several factors, such as the differential vulnerability of the various regions of the brain-to-alcohol insult. In this study, groups of timed-pregnant rats were exposed to different doses of alcohol (EtOH 2.25, EtOH 4.5, EtOH 6.5 g/kg/day) or control conditions (maltose dextrin solution or no treatment) from embryonic day 1 (E1: sperm positive) to E20. On E33 (usually postnatal day 10), all pups were perfused. Their brains were removed, dissected into forebrain, cerebellum, and brainstem, and weighed. Blood alcohol concentrations (BACs) were measured on 4 different days of gestation, but the peak BACs across gestation for the three alcohol-treated groups averaged 142, 294, and 413 mg/dl for the EtOH 2.25, EtOH 4.5, and EtOH 6.5 g/kg groups, respectively. Analysis of the body weight data indicated that pups in the EtOH 6.5 g/kg group had a greater somatic growth deficit than pups from all other groups. Although the whole brain, forebrain, cerebellum, and brainstem weights of pups in the EtOH 6.5 g/kg group were significantly smaller than those in the control groups, within-treatment group analyses indicated that the cerebella of pups in the EtOH 6.5 g/kg group were more severely affected than were their forebrains or brainstems. The analyses of the brain region to body weight ratios revealed again that the cerebellum-to-body-weight ratio of pups in the EtOH 6.5 g/kg group was more severely affected than the forebrain or brainstem to body weight ratios. Collectively, these data lend support to the view that gross regions of the brain are differentially vulnerable to alcohol insult during the first two trimesters equivalent, and suggest that the cerebellum is vulnerable to injury from exposure to high BACs during a developmental period other than the third trimester equivalent.

Fetal alcohol exposure and temporal vulnerability: regional differences in cell loss as a function of the timing of binge-like alcohol exposure during brain development

This study was conducted to determine the temporal and regional vulnerability of the brain as a function of exposure to alcohol during brain development. Our goal was to manipulate the timing of alcohol exposure and assess the relative risk of cell loss in two different brain regions. Groups of timed pregnant Sprague-Dawley rats received binge-like alcohol exposure during either the first 10 days (first-trimester equivalent) or second 10 days of gestation (second-trimester equivalent), or the combination of first- and second-trimester equivalents for prenatal treatments. Offspring from some of the animals exposed to alcohol during the combined first- and second-trimester equivalent were reared artificially from postnatal days (P) 4 through 9 (part of the third-trimester equivalent) and also received binge-like alcohol during this period, producing animals that were exposed to alcohol during all three trimesters equivalent. Offspring from untreated dams were also reared artificially and received alcohol from only P4-9, thus creating animals that were exposed to alcohol only during part of the third-trimester equivalent. All pups were perfused on P10. Appropriate controls (nutritional and normally reared) were matched to every alcohol treatment combination. Peak blood alcohol concentrations were not different among the treatment groups for a given sampling time. Total cell numbers in the cerebellum (Purkinje and granule cells) and the olfactory bulb (mitral and granule cells) were estimated by the unbiased stereological technique, the optical disector. In terms of temporal vulnerability, alcohol exposure during the equivalent of all three trimesters resulted in a greater reduction in cerebellar Purkinje cell numbers compared with exposure to alcohol during the third-trimester equivalent, whereas both groups had a significant reduction in cell number compared with all other timing groups. Cerebellar granule cell number was reduced after alcohol exposure during all three trimesters equivalent, compared with all other timing groups. Alcohol exposure during the third-trimester equivalent resulted in a decrement in the number of olfactory bulb mitral cell numbers compared with all other groups, but there were no differences among the timing groups in numbers of olfactory bulb granule cells. When the cell loss in the two regions was compared within each alcohol treatment group to determine the relative regional vulnerability, the primary salient finding was that cerebellar Purkinje cells were more vulnerable to alcohol-induced loss subsequent to exposure during all three trimesters equivalent. No other regional differences were detected. These results extend earlier findings by showing that alcohol exposure during different periods of brain development results in regional differences in cell loss as a function of the timing of alcohol exposure during brain development and illustrate the variability of alcohol-induced neuronal loss.

Hyper-IgE syndrome with recurrent infections--an autosomal dominant multisystem disorder

BACKGROUND

The hyper-IgE syndrome with recurrent infections is a rare immunodeficiency characterized by recurrent skin and pulmonary abscesses and extremely elevated levels of IgE in serum. Associated facial and skeletal features have been recognized, but their frequency is unknown, and the genetic basis of the hyper-IgE syndrome is poorly understood.

METHODS

We studied 30 patients with the hyper-IgE syndrome and 70 of their relatives. We took histories, reviewed records, performed physical and dental examinations, took anthropometric measurements, and conducted laboratory studies.

RESULTS

Nonimmunologic features of the hyper-IgE syndrome were present in all patients older than eight years. Seventy-two percent had the previously unrecognized feature of failure or delay of shedding of the primary teeth owing to lack of root resorption. Common findings among patients were recurrent fractures (in 57 percent of patients), hyperextensible joints (in 68 percent), and scoliosis (in 76 percent of patients 16 years of age or older). The classic triad of abscesses, pneumonia, and an elevated IgE level was identified in 77 percent of all patients and in 85 percent of those older than eight. In 6 of 23 adults (26 percent), IgE levels declined over time and came closer to or fell within the normal range. Autosomal dominant transmission of the hyper-IgE syndrome was found, but with variable expressivity. Of the 27 relatives at risk for inheriting the hyper-IgE syndrome, 10 were fully affected, 11 were unaffected, and 6 had combinations of mild immunologic, dental, and skeletal features of the hyper-IgE syndrome.

CONCLUSIONS

The hyper-IgE syndrome is a multisystem disorder that affects the dentition, the skeleton, connective tissue, and the immune system. It is inherited as a single-locus autosomal dominant trait with variable expressivity.

Soluble proteins modified with acetaldehyde and malondialdehyde are immunogenic in the absence of adjuvant

Recent studies have shown that the alcohol metabolites malondialdehyde and acetaldehyde can combine to form a stable adduct (MAA) on proteins. This adduct has been detected in the livers of rats chronically consuming ethanol, and serum antibodies to MAA have been observed at significantly higher concentrations in ethanol-fed when compared with pair-fed or chow-fed control rats. More recently, preliminary studies have strongly suggested that the MAA adduct is capable of stimulating antibody responses to soluble proteins in the absence of adjuvants. The antibodies produced recognize either the MAA epitope or the carrier protein itself. Therefore, it was the purpose of this study to examine the potential immunogenicity of MAA-modified exogenous proteins in the absence of adjuvants. Balb/c mice were immunized in the presence or absence of adjuvant with different concentrations of unmodified or MAA-modified proteins. The antibody response to both the MAA epitope and unmodified protein epitopes were determined by ELISA. In the absence of adjuvant, significant antibody responses were induced to both the MAA epitope and nonmodified protein epitopes. Smaller immunizing doses of MAA-protein conjugate favored the production of antibodies to nonmodified proteins, whereas larger doses induced a strong anti-MAA response. In studies to begin determining a mechanism for the specificity of the response in the absence of adjuvants, peritoneal macrophages were found to bind and degrade MAA-adducted proteins through the use of a scavenger receptor. This indicated that MAA-adducted proteins may be specifically taken up and epitopes presented to the humoral immune system in the absence of adjuvants. Importantly, these are the first data showing that an alcohol-related metabolite can induce an antibody response in the absence of adjuvant and suggesting a mechanism by which antibody to the MAA adduct or its carrier (exogenous or endogenous) proteins may be generated in vivo.