Genetic hypertension. A direct link to salt

The basis of one type of inherited hypertension has been discovered-it is caused by mutations in the gene for the beta subunit of a renal sodium channel.

Persistence and transmission of tick-borne viruses: Ixodes ricinus and louping-ill virus in red grouse populations

The population dynamics of tick-borne disease agents and in particular the mechanisms which influence their persistence are examined with reference to the flavivirus that causes louping-ill in red grouse and sheep. Pockets of infection cause heavy mortality and the infection probably persists as a consequence of immigration of susceptible hosts. Seroprevalence is positively associated with temporal variations in vectors per host, although variation between areas is associated with the abundance of mountain hares. The presence of alternative tick hosts, particularly large mammals, provides additional hosts for increasing tick abundance. Grouse alone can not support the vectors and the pathogen but both can persist when a non-viraemic mammalian host supports the tick population and a sufficiently high number of nymphs bite grouse. These alternative hosts may also amplify virus through non-viraemic transmission by the process of co-feeding, although the relative significance of this has yet to be determined. Another possible route of infection is through the ingestion of vectors when feeding or preening. Trans-ovarial transmission is a potentially important mechanism for virus persistence but has not been recorded with louping-ill and Ixodes ricinus. The influence of non-viraemic hosts, both in the multiplication of vectors and the amplification of virus through non-viraemic transmission are considered significant for virus persistence.

The population dynamics of microparasites and vertebrate hosts: the importance of immunity and recovery

The models of Anderson and May on the dynamics of vertebrate (1979, Nature 280, 361-367) and invertebrate (1981, Philos, Trans. R. Soc. 291, 451-524) populations and their microparasites have been extended and elaborated. Hence, in a series of models the effects of a range of biological factors have been considered. These models taken together clarify in particular the effects of recovery from the disease back to a state of susceptibility and the additional effects of recovery to a state of immunity. In general recovery increases both the threshold density and the equilibrium density but does not alter the prevalence of infection or the region in parameter space in which the host is regulated. Immunity causes a further increase in the equilibrium density, does not alter either the prevalence of infection or the threshold density, but reduces the region in which there is regulation. In both cases exceptions tend to occur when there is density dependence.

Assessment of risk factors for development of work-related musculoskeletal disorders (RSI)

This paper describes an approach to assessing the exposure to risk factors for the development of work-related chronic musculoskeletal disorders (repetitive strain injuries) of the upper limbs and low back. Instrumentation has been developed that combines a video image of the worker performing the task with superimposed quantitative information on risk factors. A description of the methodology, the rationale for the quantities displayed and workplace examples are presented. Continuous monitoring with both muscle activation and video has been found to be useful for identifying risk factors for both acute and chronic injuries in many workplaces. The approach gives information on chronic low-level loading not easily identified with observational methods. The methods presented give quantified information necessary for exposure measures in epidemiological studies. They also give semi-quantified information useful for identifying risks and justifying changes as well as for presentation to non-technical audiences.

Newcastle disease in wild water birds in western Canada, 1990

This report describes the investigation of mortality of double-crested cormorants (Phalacrocorax auritus), white pelicans (Pelecanus erythrorhynchos), and gulls (Larus spp.) in Alberta, Saskatchewan, and Manitoba during late summer 1990. Techniques used varied among areas, but virological and histopathological examination of birds was done in each area. The major clinical sign in cormorants was inability to fly, often with unilateral wing or leg paralysis. Focal nonsuppurative inflammation was present in the brain and spinal cord of cormorants and pelicans. Newcastle disease virus (NDV) was isolated from cormorants, a pelican, and a ring-billed gull (Larus delawarensls) from Saskatchewan. Cormorants from Alberta were positive for NDV in an immunofluorescent test. Most of the viruses were classed as velogenic and all had a similar monoclonal antibody profile to viruses from the 1970 to 1974 panzootic. Approximately half of cormorant, pelican, and gull eggs collected from affected colonies in the spring of 1991 had antibody to NDV. Antibody was also present in cormorant eggs from the Great Lakes. No unusual mortality was detected at any colony in 1991. Fledgling cormorants and gulls from colonies where mortality occurred in 1990 did not have antibody to NDV in June-July 1991. The overall extent of mortality among water birds and the source of the virus were not determined.

Cardiac responses of young women to conditioning for a 10 kilometer race

Seven previously sedentary women (mean age, 19 yrs) participated in an 11-week running program (4-5 sessions/week) in preparation for a 10 km race. Training intensity was 80-85% of maximum heart rate reserve. Exercise duration began at 20 minutes/session and was lengthened 5 minutes/session every 2 weeks. A control group consisting of 4 women was also evaluated. Maximal oxygen uptake (VO2max, ml/kg/min) increased 11% in the trained group and decreased 6% in the control group during the study (p less than 0.05). Oxygen uptake, cardiac output (Q), and stroke volume (SV) increased significantly (p less than 0.05) in the trained group during each of 3 levels of steady state cycle ergometer exercise (heart rate targets: 115, 135 and 155 beats/min, respectively). Arteriovenous oxygen difference (a-V02 diff) was not increased significantly after training. Resting left ventricular dimensions and performance evaluated by echocardiography also did not change significantly after training. It was concluded that short-term conditioning in this population results in an increased exercise Q without concomitant increases in left ventricular dimensions or arteriovenous oxygen difference.

Relationships between cardiac dimensions, anthropometric characteristics and maximal aerobic power (VO2max) in young men

Echocardiographic dimensions, anthropometric data and maximal oxygen uptake (VO2max) were studied in 26 healthy sedentary male controls (mean age, 22.0 yrs) and 15 male endurance athletes (mean age, 20.3 yrs). Athletes displayed significantly greater mean values for left ventricular internal dimension at end-diastole (LVIDd), end-diastolic volume (LVEDV) and left ventricular mass (LVM). Statistically significant positive correlations were observed within the sedentary control group between left ventricular end-diastolic dimensions (LVIDd, mm and/or LVEDV, cm3) and body height (cm), body weight (kg), chest circumference (cm) and body surface area (m2). Left ventricular mass (LVM, g) correlated significantly with lean body mass (kg). Ectomorphic somatotype rating (Ecto) correlated negatively with LVEDV and LVM. Finally, VO2max (l/min) correlated significantly with LVIDd, LVEDV and LVM. Multiple linear regression analysis indicated that the degree of endomorphy (Endo), LVIDd (mm/m2) and chest circumference accounted for 89% of the variance in VO2max (ml/kg/min) within the athlete group. Endo, Ecto and LVIDd (mm/m2) accounted for 86% of the variance in VO2max (ml/kg/min) in the control group. This study supports the hypothesis that maximal aerobic power can be predicted from cardiac and anthropometric measurements.

Prenatal diagnosis and successful intrauterine treatment of a female fetus with 21-hydroxylase deficiency

OBJECTIVE

To present the first reported Australian case of prenatal treatment of a female fetus with congenital adrenal hyperplasia resulting from 21-hydroxylase deficiency.

CLINICAL FEATURES

A couple whose son had congenital adrenal hyperplasia resulting from 21-hydroxylase deficiency sought prenatal diagnosis and treatment in their next pregnancy.

INTERVENTION

Maternal treatment with dexamethasone was commenced at seven weeks' gestation to suppress androgen production by the fetal adrenal glands and prevent virilisation of an affected female fetus. At ten weeks' gestation chorionic villus sampling demonstrated a female fetus, who was shown subsequently to be affected by means of a linkage method in which probes to HLA genes DQA and DRB were used as markers for the 21-hydroxylase genes. Increased 17-hydroxyprogesterone and androstenedione immunoactivity in amniotic fluid obtained at 14.5 weeks confirmed the fetus to be affected and demonstrated incomplete suppression of fetal adrenal androgen production. Dexamethasone was continued to term and maintained suppression of the fetal and maternal adrenal glands.

OUTCOME

The infant was born with normal female genitalia. Growth retardation was present but the relationship between this and the dexamethasone treatment remains uncertain. The mother had excessive weight gain during pregnancy.

CONCLUSION

Dexamethasone treatment commenced in the first weeks of pregnancy can prevent or reduce virilisation of female fetuses with congenital adrenal hyperplasia resulting from 21-hydroxylase deficiency.

Echocardiographic assessment of tricuspid regurgitation during ventricular demand pacing

Twenty patients from our pacemaker clinic population were assessed clinically and by saline contrast echocardiography (subxiphoid view) to determine the prevalence of tricuspid regurgitation (TR) and, if TR was present, its mechanism. The patients had no known TR before lead placement, a single transvenous right ventricular pacing lead present more than 6 months (mean 52, range 7 to 138), ventricular demand pacing alternating with sinus rhythm and rate programmability. Each patient was studied in sinus rhythm and during ventricular pacing. Using the criterion of inferior vena cava (IVC) contrast reflux during ventricular systole to diagnose TR, no patient had evidence of TR in sinus rhythm, consistent with clinical examination. During ventricular demand pacing, jugular venous pulse cannon A waves developed in 10 patients, and 18 patients (including these 10) had IVC contrast reflux during ventricular systole. Analysis of the timing of IVC reflux revealed its close temporal relation to the timing of atrial systole rather than a fixed timing during ventricular systole. This reflux occurred with loss of normal atrioventricular (AV) synchrony and the underlying mechanism in all cases was shown to be right atrial contraction against a closed tricuspid valve. Two patients who did not have such a pattern with pacing maintained normal AV synchrony. These observations indicate that: TR is an uncommon accompaniment of ventricular demand pacing; the jugular venous pulse and IVC echocardiographic contrast patterns during ventricular demand pacing simulate TR when AV asynchrony [corrected] occurs; and the IVC contrast pattern of pacing induced AV asynchrony [corrected] is best termed the cannon A wave synchronous pattern.

Molecular properties of the apamin-binding component of the Ca2+-dependent K+ channel. Radiation-inactivation, affinity labelling and solubilization

Radiation-inactivation was used to assess the functional size of the apamin-binding component of the Ca2+-dependent K+ channel. The amount of specific binding of 125I-apamin to receptors in synaptic membranes of rat cortex decayed exponentially with increasing doses of ionizing radiation and target size analysis was consistent with a relative molecular mass of 250 000 +/- 20 000 for the 125I-apamin receptor. Analysis on sodium dodecyl sulfate gels following covalent cross-linking of 125I-apamin to its receptor in a synaptosomal membrane preparation from rat cortex revealed a single labelled polypeptide chain of Mr = 33 000 +/- 2000 in the presence of protease inhibitors. Our results suggest that the Ca2+-dependent K+ channel from rat cortex is an oligomeric structure of Mr = 250 000 +/- 20 000 containing an apamin-binding subunit of Mr = 33 000 +/- 2000. The apamin-binding component of the Ca2+-dependent K+ channel from rat synaptosomes was solubilized using detergents such as sodium cholate or 3-[(3-cholamidopropyl)dimethylammonio]-1-propane sulfonate. Phospholipids did not increase the stability of the apamin-binding component during the solubilization. Binding of apamin to its solubilized receptor is reversible and saturable. The dissociation constant of the apamin-receptor complex is 40-150 pM, the rates constants of association and dissociation being 3.2 X 10(6) M-1s-1 and 1.4 X 10(-4)s-1 respectively. These binding characteristics are similar to those found for the membrane-bound apamin receptor.

Amniotic fluid prostanoids in preeclampsia

Amniotic fluid from 19 patients with preeclampsia was compared with samples from normotensive control subjects with respect to the levels of prostaglandin 6-keto prostaglandin F1 alpha, thromboxane B2, and the ratio of 6-keto prostaglandin F1 alpha to thromboxane B2. The study found no significant differences in the levels of these prostanoids or the ratio of 6-keto prostaglandin F1 alpha to thromboxane B2 (study patients, 2.7 +/- 2.1; control patients, 2.8 +/- 1.9) between groups.

Measurement of phosphatidyl glycerol in amniotic fluid. Results in clinical practice

A relatively rapid, unidimensional method of measuring phosphatidyl glycerol (PG) in amniotic fluid in order to assess pulmonary maturity was compared with measurement of the lecithin/sphingomyelin (L/S) ratio and the bubble test. Measurement of PG alone gave a higher predictive value (95%) than the L/S ratio while maintaining a low ratio rate of false-positive (2,3%) and false-negative results (3,1%).

Inexpensive quality television camera suitable for use with operating microscope

Video monitoring and video recording are useful in ophthalmic microsurgery for self-instruction and improvement, increased interest by operating room personnel, transfer of useful information to other physicians and improvement of technique. Specialized video cameras for such use are expensive. There is, however, a newly-marketed, inexpensive and light-weight video camera, which was designed for electronic newsgathering purposes, and which can be modified for microsurgery application, providing excellent results.

Auditory brain stem response abnormalities in severely and profoundly retarded adults

The auditory brain stem evoked responses (ABRs) of two groups of retarded adults (Down's syndrome and retarded of unknown etiology) were compared with those of a group of non-retarded control subjects as a function of changes in stimulus repetition rate and stimulus intensity. The absence of ABRs at the highest stimulus intensity suggested profound hearing deficits in one or both ears of 4 Down's syndrome and 2 unknown-etiology subjects. Other abnormalities were noted in particular individuals of each group of retarded. In addition, the ABRs of the Down's group as a whole showed a significant pattern of abnormalities. The intervals between peaks I and II and III and IV were shorter than normal white the IV--V interval was prolonged. Wave V also showed abnormally small latency increases at fast click rates. The ABRs of the unknown-etiology group showed a shortened III--IV interval and a prolongation of the IV--V interval, but were otherwise not significantly different from the normal controls. These data suggest a high incidence of hearing loss in both diagnostic categories studies, and abnormal functioning of the auditory brain stem pathway in the Down's syndrome group as a whole.

Brain stem auditory evoked response development in the kitten

The development of brain stem auditory evoked responses (BAERs), recorded from a surface electrode as short-latency, volume-conducted potentials, was studied in a series of kittens over a postnatal period ranging from birth to 60 days. Repeated, longitudinal observations on particular kittens were supplemented with observations on additional kittens during the first and second postnatal week to determine age of onset of the BAERs. The position of the animal and sound source within the recording chamber were held constant across recording sessions, as was click intensity except during recordings in which intensity effects were specifically studied. Click rates of 1, 10, 50 and 100/sec were routinely presented. Reference electrodes at the tongue, pinna and neck showed volume-conducted responses to the click stimuli and resulted in considerable distortion of the activity recorded by the vertex electrode; the forepaw, in contrast, showed no activity and a vertex-forepaw electrode configuration provided good resolution of the BAERs across development. A number of new observations were made. BAERs were first observed at 4 days of age, approximately the same age at which depth evoked potentials are first recorded in brain stem auditory nuclei. Initially the BAERs were diffuse, high threshold and fatigued rapidly, characteristics shared with depth evoked potentials in the early postnatal period. Over the first two weeks, the potentials showed marked decrease in threshold, increased resistance to fast click rates, and better definition of wave forms. All BAER components showed exponential decreases in latency. Because all of the brain stem evoked potentials could be recorded concurrently and longitudinally in the same subject a number of developmental comparisons were possible among the BAER components. Wave 1, related to the acoustic nerve in the adult cat, showed a developmental time course and adult latency similar to that reported for N1. Wave 2, related to the cochlear nucleus in the adult, showed a marked bimodality over the first month; wave 2a was a large amplitude clearly separated wave which gradually fused as an inconspicuous leading shoulder on wave 2b. Wave 2b developed with a time course and adult latency similar to that reported for the ventral cochlear nucleus. Wave 3, related to the region of the superior olivary complex in the adult, showed a clear but transient bimodality during the third week of development. Wave 5, related to the inferior colliculus in the adult, appeared later than waves 1-4 and showed a significantly slower rate of development than waves 1-4. These data indicate that differential developmental changes occur within the brain stem auditory pathway and that the BAERs provide a dynamic probe of concurrent maturational interactions.