Trichophyton asthma: sensitisation of bronchi and upper airways to dermatophyte antigen

12 adult patients with perennial asthma and chronic skin infection were found to have immediate hypersensitivity to Trichophyton spp. 10 patients were tested by bronchial provocation and gave immediate bronchial reactions to an extract of T tonsurans. Double-blind, placebo-controlled nasal challenge of 8 patients demonstrated that the upper airways of these patients were also sensitive to this dermatophyte antigen. In addition to perennial asthma most of the patients had persistent eosinophilia and chronic rhinosinusitis. The results suggest that absorption of fungal antigen can give rise to IgE antibody production, sensitisation of the airways, and symptomatic asthma and rhinosinusitis. Several patients had many of the features of late onset or "intrinsic" asthma.

Mitochondrial DNA polymorphism in Calabria (southern Italy)

Restriction Fragment Length Polymorphism (RFLP) of mitochondrial DNA (mtDNA) has been investigated in a sample from Calabria (Southern Italy). Seven restriction endonucleases (HpaI, BamHI, HaeII, MspI, AvaII, HincII and PstI) have been employed on 60 mtDNAs from placentas. Two new morphs have been identified (PstI-3Cal and AvaII-24Cal) and the respective polymorphic sites have been located by double digestion. Two new types (74 and 75) have also been identified and their possible origin from other known mtDNA types has been suggested.

Breathlessness, chronic bronchitis and reduced pulmonary function as predictors of cardiovascular disease mortality among men in England, Scotland and the United States

Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of chronic bronchitis, and pulmonary function are investigated among men in two employed populations (17,717 London civil servants and 4904 Scottish workers) and in two communities (844 men in Tecumseh, Michigan and 6859 men in Renfrew and Paisley Burghs, Scotland). Men are aged 40-64 years at entry in all studies except Renfrew-Paisley, where they are aged 45-64 years. Length of follow-up ranges from 6 to 16 years. Age and smoking habits were controlled for in all analyses. Chronic phlegm production is not significantly associated with CVD mortality, and 'chronic bronchitis' is significantly associated with mortality only in the employed populations. Low FEV1 is significantly associated with CVD mortality only in the Whitehall study; however, the rate ratios are above one in all studies. Breathlessness is significantly associated with CVD mortality in all studies. These associations between CVD mortality and 'chronic bronchitis', low FEV1, and breathlessness persist after also controlling for employment grade, systolic blood pressure, antihypertensive medication, ECG changes, plasma cholesterol level, body mass index and diabetes. Only the associations between breathlessness and mortality persist after further controlling for low FEV1 and myocardial ischaemia. The rate ratios between breathlessness and mortality are about two for all studies. It is concluded that in these populations, breathlessness is an independent and major predictor of CVD mortality.

The INTERSALT study: main results, conclusions and some implications

INTERSALT is an epidemiological study of electrolyte excretion and blood pressure in 10,079 men and women from 52 centres and 32 countries. The data were collected according to strict protocol with extensive quality control, and were analysed both in individuals and across centres. In the individual analysis, with adjustment for confounding variables, significant positive associations were observed between blood pressure and twenty-four hour sodium excretion, body mass index and alcohol intake, and significant negative associations between blood pressure and potassium excretion. For a number of reasons, it is likely that the size of these relationships was underestimated. Across centres, linear slope of blood pressure with age was positively related to median sodium excretion. These observations imply that a policy combining changes in sodium and potassium intake with reductions in obesity and alcohol consumption could bring important public health benefits.

Temporal hyperacuity in single neurons of electric fish

Behavioural studies have revealed that animals can resolve temporal disparities in the microsecond range. This resolution is far superior to that of individual receptors, and it must therefore be achieved through central neuronal mechanisms. It is unclear, however, whether such sensitivity ever emerges at the level of single neurons, or whether it is apparent only at the behavioural level through the collective action of many less-sensitive neurons. We have found that single neurons in the pre-pacemaker nucleus of a weakly electric fish are sensitive to temporal disparities as small as 1 microsecond, the highest temporal sensitivity ever observed at the single-neuron level. The remarkable temporal resolution of these pre-pacemaker neurons results from a high degree of spatial convergence of afferent inputs. These neurons represent the final elements of a sensory hierarchy and directly control the jamming avoidance response by which these fish regulate the frequency of their electric organ discharges.

Nasal and hand carriage of Streptococcus pneumoniae in children and mothers in the Tari Basin of Papua New Guinea

Nasal and hand carriage of Streptococcus pneumoniae was looked at in 55 families. Overall nasal carriage was 61% (83% in children and 33% in mothers). Hand carriage was 14%. Just over half of the mothers who carried pneumococcus were concordant with their infants.

Correlation of IgA2 serum levels in parent-offspring pairs

IgA2 serum levels were measured by ELISA in 120 healthy subjects from 40 nuclear families (both parents and one offspring). No sex-associated difference was observed. Moreover, the IgA2 serum levels proved to be significantly correlated in parent-offspring pairs (r = 0.55; P less than 0.001), while there was no significant correlation in mother-father pairs of the same family. The data suggest that the serum level of the IgA2 subclass is genetically controlled.

Mortality of employees of the Atomic Weapons Establishment, 1951-82

A total of 22,552 workers employed by the Atomic Weapons Establishment between 1951 and 1982 were followed up for an average of 18.6 years. Of the 3115 who died, 865 (28%) died of cancer. Mortality was 23% lower than the national average for all causes of death and 18% lower for cancer. These low rates were consistent with the findings in other workforces in the nuclear industry and reflect, at least in part, the selection of healthy people to work in the industry and the disproportionate recruitment of people from the higher social classes. At some time during their employment 9389 (42%) of the workers were monitored for exposure to radiation, the average cumulative whole body exposure to external radiation being 7.8 mSv. Their mortality was generally similar to that of other employees, even when exposures were lagged by 10 years. The rate ratio after a 10 year lag in workers with a radiation record compared with other workers was 1.01 (95% confidence interval 0.92 to 1.10) for all causes of death and 1.06 (0.89 to 1.27) for all malignant neoplasms. The only significant differences were for prostatic cancer (rate ratio 2.23; 95% confidence interval 1.13 to 4.40) and for cancers of ill defined and secondary sites (rate ratio 2.37; 1.23 to 4.56). Cancers of lymphatic and haemopoietic tissues were notable for their low occurrence in the study population, with only four deaths from leukaemia and two from multiple myeloma in workers with a radiation record, 9.16 and 3.55 deaths respectively being expected on the basis of national rates. Among workers who had a radiation record 3742 (40%) were also monitored for possible internal exposure to plutonium, 3044 (32%) to uranium, 1562 (17%) to tritium, 638 (7%) to polonium, and 281 (3%) to actinium. In these workers mortality from malignant neoplasms as a whole was not increased, but after a 10 year lag death rates from prostatic and renal cancers were generally more than twice the national average, these excesses arising in a small group of workers monitored for exposure to multiple radionuclides. Though mortality from lung cancer in workers monitored for exposure to plutonium was below the national average, it was some two thirds higher than in other radiation workers, the excess being of borderline statistical significance. Mortality from malignant neoplasms as a whole showed a weak and non-significant increasing trend with increasing level of cumulative whole body exposure to external radiation. When the exposures were lagged by 10 years the trend became stronger and significant, the estimated increase in relative risk per 10 mSv being 7.6% (95% confidence interval 0.4% to 15.3%). This trend was confined almost entirely to workers who were also monitored for exposure to radionuclides (p<0.001), the main contributions coming from lung cancer and prostatic cancer. Exposures of the lung and prostate from internal sources of radiation were not quantified, except for the contribution from tritium. It was therefore not possible to assess the extent to which the associations were due to internally deposited radionuclides rather than external exposure. The finding for prostatic cancer taken in conjunction with the results of other studies suggest a specific occupational hazard in a small group of workers in the nuclear industry who had comparatively high exposures to external radiation and who were also monitored for internal exposure to multiple radionuclides. Research is needed to discover whether any of the radionuclides and other substances concerned are concentrated in the prostate. The occurrence of lung cancer in this workforce requires further investigation taking into account smoking habits and tissue doses from inhaled radionuclides.

IGHG1 phenotypes in three population samples from Italy (Albanians, Calabrians, northern Italians): a critical revision

This paper presents data on the distribution of IGHG1 phenotypes in three populations living in Italy (Albanians, Calabrians and Northern Italians). IGHG1 typing for the allotypes z, x, a, f has been performed by using standard antisera provided by the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service (Amsterdam). The results are compared with those obtained for the same populations using alloantisera from polytransfused subjects and Behringwerke antisera. It is shown that the results obtained by using the different antisera are not in agreement. Moreover, standard antisera reveal that the IGHG1 za haplotype is more frequent in Albanians than in Northern Italians.

Flow properties of modified packed red cells

We investigated free gravitational blood flow of modified packed red cells. Variables affecting free flow included final haematocrit, duration of blood storage at 4-6 degrees C and the centrifugal force required in preparation of this blood component. Irrespective of the duration of storage, free blood flow of modified packed red cells was not different from whole blood, provided the haematocrit did not exceed 0.63.

Prognosis in adult asthma: a national study

Although one million people consult their general practitioners for asthma each year, data on the prognosis of this disease are scarce, particularly in adults. Mortality was studied among 2547 adult asthmatics attending a national sample of 60 general practices between 1970 and 1976; they were compared with a matched group of non-asthmatic patients. Mortality from all causes was significantly raised in the asthmatic cohort (189 deaths v 112 among controls; relative risk 1.61, 95% confidence interval 1.3 to 2.0), especially in women (92 v 42 deaths; relative risk 2.2 (1.5 to 3.1)), and in the oldest age group (55-59 years). In both sexes the predominant cause of excess mortality was respiratory disease, particularly asthma (25 v 0 deaths) and chronic obstructive airways disease (37 v 4 deaths; relative risk 8.8 (2.8 to 23)). Overall, 94% of the asthmatic cohort survived the mean follow up period of eight years compared with 96% of the controls. In contrast to previous findings, the risk of death due to malignant neoplasms was not significantly reduced overall (34 v 36 deaths), though the risk was significantly reduced among those aged under 45 years (2 v 10 deaths; relative risk 0.2 (0.02 to 0.9)) and there was a significant trend of lowering of relative risk with younger age (p less than 0.01).

Review of primary prevention trials

The main threat to patients with mild to moderate hypertension is coronary heart disease (CHD), but controlled trials of antihypertensive drug therapy have given disappointing results: overall, the reduction in CHD mortality (11%) and morbidity (10%) were small and nonsignificant. Recent trials comparing a beta blocker with other antihypertensive drugs have not shown the "cardioprotection" expected from their pharmacologic actions and from their effectiveness after myocardial infarction; but two large trials have suggested some reduction in CHD among male nonsmokers. Relaxation with biofeedback possibly lowers CHD risk. Although the trials indicate that drugs generally do little to reduce CHD in hypertensive patients, control of smoking and serum cholesterol may be more effective.

Neonatal exposure to a high level of ACTH4-10 impairs adult learning performance

Male offspring of Sprague-Dawley dams were injected with 25 micrograms of ACTH4-10 or the vehicle on days 2 through 7 postpartum. Peptide treated animals exhibited a marked motor response to the peptide injection. Adrenal weights of these animals were consistently heavier than littermate controls in both the developing and adult animals. ACTH4-10 treated neonates exhibited significantly poorer learning performance in the shuttle box and were slower to acquire the reversal learning problem of a visual discrimination task under light shock levels. In addition, these animals also exhibited an exaggerated startle response and a stronger thigmotaxis response in the open field than controls. These results indicate that exposing the developing nervous system to relatively high levels of ACTH4-10 can produce marked long-term effects on behavior.

Twenty year follow up of patients in the Medical Research Council trial of anticoagulants in acute myocardial infarction

A 20 year follow up of 1330 patients in the Medical Research Council trial of short term anticoagulant treatment in myocardial infarction showed no long term benefits; but it provided interesting data on the outcome in such patients. Sixteen per cent of the patients were alive 20 years later. The excess mortality rate in trial participants over that expected for England and Wales as a whole declined rapidly after the early months, but some excess persisted throughout the follow up. Three quarters of all the deaths were from coronary heart disease; 70% of these coronary deaths occurred after the patients had left hospital. This finding emphasises the importance of secondary prevention.

'Ancestral' neural mechanisms of electrolocation suggest a substrate for the evolution of the jamming avoidance response

The genus Sternopygus, believed to reflect ancestral traits of gymnotiform electric fish, is closely related to the more 'modern' genus Eigenmannia (Mago-Leccia 1978; Fink and Fink 1981). Sternopygus is the only known genus of electric fish that does not perform a jamming avoidance response (JAR) to minimize the potentially detrimental effects of signal interference between discharging neighbors (Bullock et al. 1972, 1975), and its ability to electrolocate objects is rather immune to jamming (Matsubara and Heiligenberg 1978). By studying the responses of midbrain neurons to stimulus regimes effective in eliciting the JAR in Eigenmannia, we found that Sternopygus has neurons capable of discriminating the sign of the difference frequency between interfering electric organ discharges (EODs). These 'sign-selective' neurons, which are believed to be important elements in the control of the JAR in Eigenmannia, may, therefore, fulfill a more general function in the detection of moving objects and conspecifics but could potentially be assembled for the evolution of a JAR in Sternopygus. The relative immunity to jamming in this genus may result, in part, from a stronger reliance upon the ampullary electrosensory system which operates in the DC and low-frequency range, outside the EOD spectrum of these fish.

Risk of stroke in non-rheumatic atrial fibrillation

Estimates of the risk of stroke for men with non-rheumatic atrial fibrillation were obtained from two large cohort studies--the Whitehall Study of London Civil Servants and the British Regional Heart Study. The first cohort provided an estimated relative risk of stroke of 6.9 compared with controls. This increased risk confirms that of the other prospective estimate, 5.6, found in the Framingham study. In the second cohort only one of the men at risk had a stroke, and the risk estimate did not differ significantly from unity. The absolute rates of stroke in both cohorts were lower than those reported in the Framingham study, implying a lesser potential benefit from preventive measures. These lower rates should be considered in the planning of trials. The risk of stroke was significantly associated with raised systolic or diastolic blood pressure but not with age or coronary heart disease.