A comprehensive overview by region of condoms, natural family planning, and spermicide as a contraceptive method among men aged 13-54 years attending contraceptive services in England

OBJECTIVES

This study aimed to (1) provide a comprehensive overview of contraceptive methods self-reported by men in England, over 5 years, focusing on condoms in comparison to any male method; and (2) explore condom as a contraceptive method by region and ethnicity.

STUDY DESIGN

Data were from the Sexual and Reproductive Health Services (Contraception) England census data set from 2014/15 to 2018/19. Once missing data were removed, this left a total of 365,292 men. Two binomial logistic regression models were performed. Model 1 examined ethnicity, region, and time on condom as a method of contraception; and Model 2 examined ethnicity, region, and time by any male contraceptive. Descriptive statistics were run for natural family planning and spermicide.

RESULTS

Model 1 revealed a significant model, χ² (15) = 30,976, P < 0.001, and predicted that condoms as a method decreased in London with a greater decrease in Midlands. London saw the lowest rate of decline among the non-White ethnic group, whereas North and South regions increased probability over time. The North started at a higher probability and the South at the lowest. Model 2 also revealed a significant model, χ² (15) = 32,472, P < 0.001, with a similar pattern to Model 1. Contingency tables showed natural family planning and spermicide were the least reported methods and decreased over time.

CONCLUSIONS

As any male contraceptive method appears to be decreasing in both models, reproductive health promotion is required. This study has implications for commissioning funds and for identifying regional areas of further investigation.

Highly effective prophylaxis with ertapenem for transrectal ultrasound-guided prostate biopsy: effects on overall antibiotic use and inpatient hospital exposure

BACKGROUND

Ertapenem prophylaxis for transrectal ultrasound-guided prostate biopsy (TRUS-PB) has proven highly effective at our institution. A subsequent study showed no selection for carbapenem resistance, but antimicrobial stewardship concerns remained.

AIM

To assess the effects of this prophylaxis on overall antibiotic consumption and exposure to the hospital environment.

METHODS

All men undergoing TRUS-PB from November 2006 to July 2019 were included. Hospital records of men presenting within 30 days of biopsy were searched to determine whether post-biopsy infection (PBI) occurred, antibiotic usage, and duration of hospitalization. Prophylaxis during the pre-ertapenem period (period 1: 2006 to 2012) was oral ciprofloxacin for three days, with oral amoxicillin-clavulanate added in 2009. During the subsequent period (period 2: 2012 to 2019) a single intramuscular dose of ertapenem was used.

FINDINGS

From periods 1 and 2, 1663 and 2357 men, respectively, were included. Median age was 65 years for both groups. Between periods 1 and 2, PBI incidence decreased from 2.65% to 0.34% (risk ratio: 0.13; 95% confidence interval (CI): 0.06, 0.27), and PBI-related bacteraemia from 1.14% to 0.04% (0.04; 0.01, 0.22), with a single bacteraemia during period 2. PBI treatment antibiotic consumption decreased from 57.6 to 4.3 defined daily doses (DDDs) per 100 biopsies (mean difference: -53.3; 95% CI: -73.1, -33.5) and overall consumption (treatment plus prophylaxis) decreased from 580.8 to 104.3 DDDs per 100 biopsies (mean difference: -476.5). PBI-related hospitalized bed-days per 100 biopsies decreased from 9.44 to 0.89 (mean difference: -8.55; 95% CI: -12.31, -4.79).

CONCLUSION

Ertapenem prophylaxis was highly effective and resulted in marked reductions in overall antibiotic consumption and inpatient bed-days. Effective prophylaxis has advantages from an antimicrobial stewardship perspective.

'Do you know how to use a condom?' - UK nurse practitioners' conversation about men and family planning

INTRODUCTION

Health professionals have been identified as central to encouraging men to take an active part in family planning. The aim of this article is to understand nurse practitioners' conversations about men as family planning patients.

METHODS

One-to-one, semi-structured interviews were conducted with five nurse practitioners. Nurses interviewed worked in a northern UK student medical practice serving over 34,000 students with a diverse range of ages and demographic backgrounds (both home and overseas students). The research method was qualitative using discourse analysis.

RESULTS

After completing the analysis, two discourses emerged. Discourse one, family planning services are culturally female centric, and discourse two, condom use by male family planning patients is problematic.

DISCUSSION

Implications for how nurse practitioners can continue to play an important part when providing care to male family planning patients is discussed, specifically in relation to culture and condom efficacy.

Self-assembly of molecular ions via like-charge ion interactions and through-space defined organic domains

Select tertiary ammonium bicarbonates self-assemble assisted by the first bicarbonate like-charge hydrogen-bonded ion pairs documented in an aqueous solution.

Immune responses to ectoparasites of horses, with a focus on insect bite hypersensitivity

Horses are affected by a wide variety of arthropod ectoparasites, ranging from lice which spend their entire life on the host, through ticks which feed over a period of days, to numerous biting insects that only transiently visit the host to feed. The presence of ectoparasites elicits a number of host responses including innate inflammatory responses, adaptive immune reactions and altered behaviour; all of which can reduce the severity of the parasite burden. All of these different responses are linked through immune mechanisms mediated by mast cells and IgE antibodies which have an important role in host resistance to ectoparasites, yet immune responses also cause severe pathological reactions. One of the best described examples of such pathological sequelae is insect bite hypersensitivity (IBH) of horses; an IgE-mediated type 1 hypersensitivity to the salivary proteins of Culicoides spp. associated with T-helper-2 production of IL4 and IL13. Importantly, all horses exposed to Culicoides have an expanded population of Culicoides antigen-specific T cells with this pattern of cytokine production, but in those which remain healthy, the inflammatory reaction is tempered by the presence of FoxP3+ CD4+ regulatory T cells that express IL10 and TGF-beta, which suppresses the IL4 production by Culicoides antigen-activated T cells.

Evaluation of an IgE ELISA with Culicoides spp. extracts and recombinant salivary antigens for diagnosis of insect bite hypersensitivity in Warmblood horses

Insect bite hypersensitivity (IBH) in horses represents an immunoglobulin E (IgE)-mediated hypersensitivity to salivary antigens from biting midges (Culicoides spp.). The aim of this study was to evaluate and compare the performances of IgE ELISAs using recombinant Culicoides spp. Obsoletus group salivary gland antigens or crude whole body extracts ('ObsWBE'), C. nubeculosus recombinant proteins (Culn1, 3, 4, 5, 7, 8 and 10) and Obsoletus group recombinant proteins (Culo1 and 2). IgE levels were measured in plasma of 343 Warmblood horses classified as IBH-affected (n=167) and IBH-unaffected (n=176) according to the owners' descriptions. IBH-affected horses were subdivided based on the severity of their clinical signs at sampling and whether or not their IBH history was considered to be classical. The accuracies of the tests increased when clinical signs at sampling were more pronounced or when the IBH history could be considered as classical. A combination of IgE levels against the three best performing Culicoides spp. recombinant proteins (Culn4, Culo1 and Culo2) and ObsWBE resulted in the best performing test. When IBH-affected horses showing a classical history of the disease and severe clinical signs were compared with IBH-unaffected horses, the Youden's index at the optimal cut-off for the three tests in combination was 0.67. This optimal cut-off had a sensitivity of 70%, a specificity of 97% and a total accuracy of 92%. The performance of the IgE ELISA was affected by the severity of IBH clinical signs at sampling and was improved when IgE levels against several recombinant proteins were combined.

Characterisation of early and late bovine papillomavirus protein expression in equine sarcoids

Sarcoids are common skin tumours of horses and donkeys that are characterised by persistent proliferation of dermal fibroblasts associated with the presence of bovine papillomavirus (BPV) DNA. Some early BPV proteins have been demonstrated within sarcoids and RNA containing both early and late transcripts is present, yet it remains unclear whether late replication of BPV, culminating in the production of infectious virus particles, can occur in equids. Here we report that BPV1 RNA isolated from equine sarcoids encodes a unique deletion of four residues within the L2 protein suggesting a novel variant of virus has evolved in equines. Such viral evolution would require the production and transmission of virus particles among horses with sarcoids. Quantitative RT-PCR demonstrated the presence of mRNA transcripts containing early gene message in sarcoid tissues and BPV-E2 early virus antigen was detected by immunofluorescence in the nuclei of dermal fibroblasts, but no E2 expression could be detected within the overlying epidermis where productive virus replication would be expected to occur. Although immunohistochemistry clearly detected late virus proteins in the nuclei of dermal cells from samples of bovine papillomas, no late protein expression was detected in formalin-fixed tissue from equine sarcoids; either in the dermis or epidermis. Moreover, quantitative RT-PCR demonstrated that late gene mRNA represented <0.3% of the transcribed BPV RNA. We conclude that BPV does not undergo productive infection in the epidermis overlying equine sarcoids at levels comparable with that occurring in its natural bovine host.

An intronic polymorphism in the porcine IRF7 gene is associated with better health and immunity of the host during Sarcocystis infection, and affects interferon signalling

Interferon regulatory factor 7 (IRF7), as a key regulator of type I interferon response, plays an important role during innate response against viral infection. Although well conserved across species, the structure of IRF7 and its function during parasite infection are not well documented in farm animals, such as the pig. To bridge this gap, we have determined the porcine IRF7 gene structure and identified two intronic single nucleotide polymorphisms (SNPs), SNP g.748G>C and SNP g.761A>G, in commercial pig breeds. The distribution of SNP g.761A>G in multiple breeds suggested that it was in Hardy-Weinberg equilibrium and allowed us to map it at the top of SSC2. We found that during Sarcocystis miescheriana infection, the G allele was associated with high lymphocyte levels (P < 0.02), reduced drop in platelet levels (P < 0.002) and IgG1-Th2-dominated response (P < 0.05). This suggests that the G allele was associated with better health and immunity of the host during Sarcocystis infection. Furthermore, we have also provided suggestive evidence that the G allele of SNPc.761A>G enhances the transactivation activity of IRF7, possibly by improving IRF7 transcript splicing of intron-3. These findings would suggest that IRF7, as a transcriptional regulator, is involved in the defence mechanism against a larger spectrum of pathogens, and in more host species, than initially anticipated.

Identification and isolation of cDNA clones encoding the abundant secreted proteins in the saliva proteome of Culicoides nubeculosus

Culicoides spp. are vectors of several infectious diseases of veterinary importance and a major cause of allergy in horses and other livestock. Their saliva contains a number of proteins which enable blood feeding, enhance disease transmission and act as allergens. We report the construction of a novel cDNA library from Culicoides nubeculosus linked to the analysis of abundant salivary gland proteins by mass spectrometry. Fifty-four novel proteins sequences are described including those of the enzymes maltase, hyaluronidase and two serine proteases demonstrated to be present in Culicoides salivary glands, as well as several members of the D7 family and protease inhibitors with putative anticoagulant activity. In addition, several families of abundant proteins with unknown function were identified including some of the major candidate allergens that cause insect bite hypersensitivity in horses.

First Report of Amylostereum areolatum in Pines in the United States

The wood decay fungus Amylostereum areolatum (Fr.) Boidin, native to Eurasia and North Africa (4), is the mycosymbiont of several siricid woodwasps including Sirex noctilio Fabricius, a major pest of pines in New Zealand, Australia, South America, and South Africa where it has been introduced. Adult females of S. noctilio are effective vectors of arthrospores (hyphal fragments) of the fungus, stored internally within mycangia in the abdomen, which are injected with the eggs and a phytotoxic mucus into the outer sapwood of coniferous tree hosts during oviposition. The toxin is translocated upward into the foliage causing needle wilting, necrosis, and crown dieback. The fungus decays the wood (white rot) and provides food for hatching larvae that form borer galleries. Extensive damage to the host via wood decay, galleries, and toxin effects cause mortality in heavily infested trees. S. noctilio adults have been intercepted from several locations in North America prior to 2003, but there has been no evidence of an established population in any native forests until recently. In September 2004, a single adult female was collected from a funnel-trap at the edge of a forest stand in Fulton, NY (Oswego County) and identified in February 2005 (3). A local survey in May 2005 revealed red pines and Scotch pines infested with siricid larvae on the SUNY Oswego campus and in Rice Creek Nature Preserve, 3 km from campus. All larvae from infested trees were identified as S. noctilio using the DNA barcode method (2). Bole sections of infested red pines were sent to the USDA-ARS quarantine facility in Stoneville, MS. Wood samples, taken from areas of incipient decay adjacent to larval galleries, were plated onto 4.5% potato dextrose agar. Fungal colonies in pure cultures arising from wood pieces were appressed and exhibited microscopic characters typical of A. areolatum. Molecular confirmation of identifications for nine isolates was achieved by PCR amplification and sequencing of the rDNA internal transcribed spacer (ITS) region using ITS1 and ITS4 universal primer pairs. BLAST program analyses of these sequences compared against the NCBI GenBank database revealed the isolates were identical (GenBank Accession No. FJ040860) and had 98.8 to 99.8% sequence homology with five A. areolatum GenBank sequences (AF454428, AY781245, AF218389, EU249343, and EU249344) from Germany, Sweden, Japan, and Canada. To our knowledge, this represents the first confirmed isolation of A. areolatum from a native pine stand in the United States and confirms the first incidence of infections of North American pines, 16 months prior to isolations in Ontario (1). This insect vector-decay fungus complex, native to Eurasia, has a very high-risk rating and threatens many pine (Pinus) species in North America, particularly southern U.S. species that have been severely attacked and killed where introduced in the Southern Hemisphere. The lack of complete sequence homology between New York and Ontario, Canada strains of A. areolatum suggests that these recent incidences probably resulted from multiple woodwasp introductions rather than from vector (S. noctilio female) movement after one introduction. References: (1) M. J. Bergeron et al. Plant Dis. 92:1138, 2008. (2) P. D. N. Hebert et al. Proc. R. Soc. Lond. B 270:313, 2003. (3) E. R. Hoebeke et al. Newsl. Mich. Entomol. Soc. 50:24, 2005. (4) J. P. Spradbery and A. A. Kirk. Bull. Entomol. Res. 68:341, 1978.

Identification of abundant proteins and potential allergens in Culicoides nubeculosus salivary glands

IgE-mediated type 1 hypersensitivity reactions to the bites of insects are a common cause of skin disease in horses. Insect bite hypersensitivity (IBH) is most frequently associated with bites of Culicoides spp. and occurs in all parts of the world where horses and Culicoides coexist. The main allergens that cause IBH are probably some of the abundant proteins in the saliva of Culicoides associated with blood feeding. Western blots of Culicoides proteins separated by 1D gel-electrophoresis detected strong IgE responses in all horses with IBH to antigens in protein extracts from wild caught Culicoides, but only weak responses to salivary antigens from captive bred C. nubeculosus which may reflect important differences among allergens from different species of Culicoides or differences between thorax and salivary gland antigens. 2D electrophoresis and mass spectrometry were used to identify several of the abundant proteins in the saliva of C. nubeculosus. These included maltase, members of the D7 family, and several small, basic proteins associated with blood feeding. The most frequently detected IgE-binding proteins were in a group of proteins with pI>8.5 and mass 40-50kDa. Mass spectrometry identified two of these allergenic proteins as similar to hyaluronidase and a heavily glycosylated protein of unknown function that have previously been identified in salivary glands of C. sonorensis.

Cardiovascular toxicity due to venlafaxine poisoning in adults: a review of 235 consecutive cases

AIMS

Venlafaxine may increase the risk of arrhythmia in certain patients. We sought to characterize the cardiovascular effects of venlafaxine overdose in adults.

METHODS

A retrospective casenote review of patients admitted to the Royal Infirmary of Edinburgh between January 2000 and June 2006. Haemodynamic and electrocardiographic data were examined in the whole group and a subset that ingested venlafaxine alone.

RESULTS

Two hundred and thirty-five patients (65 men) with median (interquartile range) age 34 years (27-43 years) had ingested venlafaxine 1500 mg (919-2800 mg). Tachycardia (40.0%), high blood pressure (28.4%) and mydriasis (36.6%) were common. Corrected QT >450 ms occurred in seven men (11.1%) and 17 women (10.5%) and transient arrhythmia in three patients. There was a positive correlation between stated quantity of venlafaxine ingested and heart rate [rho = 0.195, 95% confidence interval (CI) 0.054, 0.328] and QTc (rho = 0.314, 95% CI 0.089, 0.509).

CONCLUSIONS

Venlafaxine overdose is associated with sympathomimetic cardiovascular effects and prolonged QTc, irrespective of coingested drugs. These mechanisms might pose an increased risk of arrhythmia and require further exploration.

Mapping of multiple quantitative trait loci for growth and carcass traits in a complex commercial sheep pedigree

The confirmation of the segregation of experimentally populations is required before their commercial design of such confirmation experiments has the the pedigree while maintaining the power to detect chromosomes of a complex pedigree of 570 Charollais contained a moderately sized half-sib family which was wide level were detected in the half-sib analysis and analysis of the complex pedigree using identity-by-estimation of QTL effects was achieved by fitting all observed in the single QTL models. Both methods of different regions, and the variance components method demonstrates the viability of applying a variance inbreeding.

VENLAFAXINE INGESTION IS ASSOCIATED WITH RHABDOMYOLYSIS IN ADULTS: A CASE SERIES

Rhabdomyolysis has been reported after venlafaxine ingestion. We wished to characterize the prevalence of this adverse effect in a realistic clinical setting. Therefore, a retrospective casenote review was performed, including 235 patients admitted to the Royal Infirmary of Edinburgh due to venlafaxine overdose between January 2000 and June 2006. Seizures occurred in 8.9% of the study population. Patients who suffered seizures had ingested larger quantities of venlafaxine than those who did not develop seizures; median (interquartile range) 2800 mg (2006-4350 mg) versus 1500 mg (900-2700 mg, p = 0.001). Raised CK values were more prevalent in those with seizures than those without seizures (61.1% versus 25.7% respectively, p = 0.004). Nonetheless, a positive correlation was found between the quantity of venlafaxine ingested and CK across the whole group (rho = 0.201, 95% confidence interval 0.045-0.347), and in patients who had not developed seizures (rho = 0.174, 95% confidence interval 0.009-0.331). Venlafaxine overdose is associated with a high prevalence of acute muscle injury, both in patients who develop seizures and in those who do not. The clinical significance of this association merits further consideration.

Equine insect bite hypersensitivity: immunoblot analysis of IgE and IgG subclass responses to Culicoides nubeculosus salivary gland extract

Insect bite hypersensitivity (IBH) is an allergic dermatitis of horses caused by IgE-mediated reactions to bites of Culicoides and sometimes Simulium spp. The allergens causing IBH are probably salivary gland proteins from these insects, but they have not yet been identified. The aim of our study was to identify the number and molecular weight of salivary gland extract (SGE) proteins derived from Culicoides nubeculosus which are able to bind IgE antibodies (ab) from the sera of IBH-affected horses. Additionally, we sought to investigate the IgG subclass (IgGa, IgGb and IgGT) reactivity to these proteins. Individual IgE and IgG subclass responses to proteins of C. nubeculosus SGE were evaluated by immunoblot in 42 IBH-affected and 26 healthy horses belonging to different groups (Icelandic horses born in Iceland, Icelandic horses and horses from different breeds born in mainland Europe). Additionally, the specific antibody response was studied before exposure to bites of Culicoides spp. and over a period of 3 years in a cohort of 10 Icelandic horses born in Iceland and imported to Switzerland. Ten IgE-binding protein bands with approximate molecular weights of 75, 66, 52, 48, 47, 32, 22/21, 19, 15, 13/12 kDa were found in the SGE. Five of these bands bound IgE from 50% or more of the horse sera. Thirty-nine of the 42 IBH-affected horses but only 2 of the 26 healthy horses showed IgE-binding to the SGE (p<0.000001). Similarly, more IBH-affected than healthy horses had IgGa ab binding to the Culicoides SGE (19/22 and 9/22, respectively, p<0.01). Sera of IBH-affected horses contained IgE, IgGa and IgGT but not IgGb ab against significantly more protein bands than the sera of the healthy horses. The cohort of 10 Icelandic horses confirmed these results and showed that Culicoides SGE specific IgE correlates with onset of IBH. IBH-affected horses that were born in Iceland had IgGa and IgGT ab (p< or =0.01) as well as IgE ab (p=0.06) against a significantly higher number of SGE proteins than IBH-affected horses born in mainland Europe. The present study shows that Culicoides SGE contains at least 10 potential allergens for IBH and that IBH-affected horses show a large variety of IgE-binding patterns in immunoblots. These findings are important for the future development of a specific immunotherapy with recombinant salivary gland allergens.

Effects of interventions aimed at changing the length of primary care physicians' consultation

BACKGROUND

Observational studies have shown differences in process and outcome between the consultations of primary care physicians whose average consultation lengths differ. These differences may be due to self selection.

OBJECTIVES

To assess the effectiveness and efficiency of interventions to alter the length of primary care physicians' consultations.

SEARCH STRATEGY

The following electronic databases were searched: Cochrane Effective Practice and Organisation of Care Group (EPOC) Specialised Register (October 2002); CENTRAL (The Cochrane Library June 2003); MEDLINE (1966 to October 2002);EMBASE (1981 to October 2002); NHS National Research Register (June 2003). The search strategies combined subject terms for 'general practice', 'consultation' and 'length' with methodological filters.

SELECTION CRITERIA

Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of interventions to alter the length of primary care physicians' consultations.

DATA COLLECTION AND ANALYSIS

Data were extracted independently by two authors using agreed criteria. Disagreements were resolved by discussion. Where data were missing attempts were made to contact authors. Given the heterogeneity of studies meta-analysis was not attempted, and results are presented as a narrative summary.

MAIN RESULTS

Six articles describing four UK trials met the inclusion criteria. All tested short term changes in the consultation time allocated to each patient and all had methodological weaknesses, particularly due to non-random allocation of patients. Altering appointment length resulted in modest changes in average length of consultation. There were no consistent differences in problem recognition, examination, prescribing, referral or investigation rates. There was some evidence that blood pressure was checked and smoking discussed more often when more time was available. None of the interventions were associated with differences in patient satisfaction. No trials examined efficiency.

AUTHORS' CONCLUSIONS

The findings of this review do not provide sufficient evidence to support or resist a policy of altering the lengths of primary care physicians' consultations. Further trials are needed that focus on health outcomes and cost effectiveness.

Mapping of quantitative trait loci for growth and carcass traits in commercial sheep populations1

Quantitative trait loci analyses were applied to data from Suffolk and Texel commercial sheep flocks in the United Kingdom. The populations comprised 489 Suffolk animals in three half-sib families and 903 Texel animals in nine half-sib families. Phenotypic data comprised measurements of live weight at 8 and 20 wk of age and ultrasonically measured fat and muscle depth at 20 wk. Lambs and their sires were genotyped across candidate regions on chromosomes 1, 2, 3, 4, 5, 6, 11, 18, and 20. Data were analyzed at the breed level, at the family level, and across extended families when families were genetically related. The breed-level analyses revealed a suggestive QTL on chromosome 1 in the Suffolk breed, between markers BM8246 and McM130, affecting muscle depth, although the effect was only significant in one of the three Suffolk families. A two-QTL analysis suggested that this effect may be due to two adjacent QTL acting in coupling. In total, 24 suggestive QTL were identified from individual family analyses. The most significant QTL affected fat depth and was segregating in a Texel family on chromosome 2, with an effect of 0.62 mm. The QTL was located around marker ILSTS030, 26 cM distal to myostatin. Two of the Suffolk and two of the Texel sires were related, and a three-generation analysis was applied across these two extended families. Seven suggestive QTL were identified in this analysis, including one that had not been detected in the individual family analysis. The most significant QTL, which affected muscle depth, was located on chromosome 18 near the callipyge and Carwell loci. Based on the phenotypic effect and location of the QTL, the data suggest that a locus similar to the Carwell locus may be segregating in the United Kingdom Texel population.

Development of conductive polymer analysis for the rapid detection and identification of phytopathogenic microbes

ABSTRACT Conductive polymer analysis, a type of electronic aroma detection technology, was evaluated for its efficacy in the detection, identification, and discrimination of plant-pathogenic microorganisms on standardized media and in diseased plant tissues. The method is based on the acquisition of a diagnostic electronic fingerprint derived from multisensor responses to distinct mixtures of volatile metabolites released into sampled headspace. Protocols were established to apply this technology specifically to plant disease diagnosis. This involved development of standardized cultural methods, new instrument architecture for sampling, sample preparation, prerun procedures, run parameters and schedules, recognition files and libraries, data manipulations, and validation protocols for interpretations of results. The collective output from a 32-sensor array produced unique electronic aroma signature patterns diagnostic of individual microbial species in culture and specific pathogen-host combinations associated with diseased plants. The level of discrimination applied in identifications of unknowns was regulated by confidence level and sensitivity settings during construction of application-specific reference libraries for each category of microbe or microbe-host combination identified. Applications of this technology were demonstrated for the diagnosis of specific disease systems, including bacterial and fungal diseases and decays of trees; for host identifications; and for determinations of levels of infection and relatedness between microbial species. Other potential applications to plant pathology are discussed with some advantages and limitations for each type of diagnostic application.

Increased heterozygosity and allele variants are seen in Texel compared to Suffolk sheep

In this study, the Suffolk and Texel sheep breeds were compared for microsatellite marker heterozygosity throughout seven chromosomal regions in the sheep genome. A total of 623 Texel animals and 489 Suffolk animals in five and three half-sib families, respectively, were genotyped for microsatellite markers across the seven different chromosomes. Using the observed allele frequencies, the expected levels of heterozygosity were calculated for each family. The expected levels of heterozygosity did not significantly differ between the breeds across all regions studied. However, levels of expected heterozygosity were 32% higher in Texel animals on chromosome 4 due to a region of increased heterozygosity between BMS648 and BM3212. The number of allelic variants significantly differed between the breeds, solely due to a region of increased number of alleles on chromosome 20. This region of higher numbers of allele variants in the Texel breed extended from the MHC to c. 15 cM distal to the MHC region incorporating markers OMHC1, CSRD226, TGLA387 and BM1818, which had 3.30, 7.02, 3.09 and 6.75 more alleles in Texel than in Suffolk animals, respectively. No difference was observed in the variance of allele frequency between the two breeds. It is proposed that previous selective sweeps may have reduced numbers of alleles and levels of heterozygosity in the Suffolk breed.

Study of crib-biting and gastric inflammation and ulceration in young horses

Nineteen young horses that had recently started to perform the stereotypy of crib-biting were compared with 16 non-stereotypic horses for 14 weeks. After initial observations of their behaviour and an endoscopic examination of the condition of their stomachs, the horses were randomly allocated to a control or an antacid diet At the start of the trial, the stomachs of the crib-biting foals were significantly more ulcerated and inflamed than the stomachs of the normal foals. In addition, the faecal pH of the crib-biting foals (6.05) was significantly lower than that of the normal foals (6.58). The antacid diet resulted in a significant improvement in the condition of the horses' stomachs. The crib-biting behaviour declined in most of the foals, regardless of their diet, but tended to decline to a greater extent in the foals on the antacid diet.

Trench Inserts as Long-term Barriers to Root Transmission for Control of Oak Wilt

Physical and chemical barriers to root penetration and root grafting across trenches were evaluated for their effectiveness in improving trenches as barriers to root transmission of the oak wilt fungus in live oaks. Four trench insert materials were tested, including water-permeable Typar and Biobarrier, and water-impermeable Geomembrane of two thicknesses. Systemic fungicide treatments of trees immediately outside of trenches also were tested. In the first several years following trench installation, an abundance of small adventitious roots commonly formed from roots severed by trenching. These roots provided opportunities for initiation of root grafts across trenches in subsequent years. Although trench inserts did not significantly improve trenches during the first 3 years following trench installation, water-permeable inserts did effectively improve the performance of trenches beyond the third posttrenching year, when trenches are normally effective, and extended trench longevity indefinitely. The water-permeable inserts were more effective root barriers because they did not direct root growth from the point of root contact. The water-impermeable materials, however, did tend to direct root growth around these barriers, leading to the development of new root graft connections and associated oak wilt root transmission across the trench. The additional cost of trench inserts above trenching costs was justified in urban and rural homestead sites, where high-value landscape trees required more protection and additional retrenching costs were avoided.

Detection of IgG and IgE serum antibodies to Culicoides salivary gland antigens in horses with insect dermal hypersensitivity (sweet itch)

We postulated that all horses exposed to the bites of Culcoides (midges) would have an antibody response to the antigen secreted in Culcoides saliva, but that IgE antibody would be restricted to allergic individuals. Using immunohistology on sections of fixed Culicoides, we have demonstrated the presence of antibodies in horse serum which recognise Culicoides salivary glands. Antibodies were detected in the serum of horses with insect dermal hypersensitivity and in the serum of normal horses exposed to Culicoides bites. In contrast, no antibodies were detected in serum from native Icelandic ponies which had not been exposed to Culicoides. Anti-salivary gland IgG antibodies were detected in serum from both allergic and healthy horses exposed to Culicoides. IgE antibodies were only detected in horses with signs of insect dermal hypersensitivity, they were not found in serum of healthy controls nor in the serum of horses with a history of hypersensitivity but in remission at the time of sampling. Using western blotting we confirmed the presence of antibodies to Culicoides antigens and demonstrated that individual horses react to different numbers of antigens. This paper demonstrates the ability of serum from allergic horses to detect Culcoides antigens and will enable further studies to isolate and characterise the allergens.

In vitro cytokine production and growth inhibition of lymphoblastoid cell lines by CD4+ T cells from Epstein-Barr virus (EBV) seropositive donors

In vitro stimulation of peripheral blood lymphocytes (PBL) from healthy Epstein-Barr Virus (EBV) seropositive individuals with autologous lymphoblastoid cell lines (LCL) gives rise to CD4+ and CD8+ T cells both of which are cytotoxic for autologous lymphoblastoid cells. Activated EBV-specific CD4+ T cells are cytotoxic towards autologous LCL but, paradoxically, CD4+ T cells have also been shown to enhance tumour formation in SCID/Hu mice. Here, we show that despite being cytotoxic, CD4+ T-cell lines from different donors show considerable variation in their ability to inhibit the long-term growth of autologous LCLs in vitro. Following re-stimulation in vitro with PMA and ionomycin, CD4+ T cells produced IFNgamma, TNFalpha, TNFbeta, IL-2, IL-4, IL-10 and IL-13. TNFalpha, TNFbeta and IL-10 production were also detected in LCL. IL-6 was only detected in trace amounts in either cell type. The ratio of IFNgamma to IL-4 production varied between the CD4+ T-cell lines, indicating differences in the Th1/Th2 balance of the response. When CD4+ T cells were re-stimulated using autologous LCL as antigen-presenting cells, they produced more IL-4 and less IFNgamma or IL-13 when compared with cells re-stimulated by phorbol myristate acetate (PMA) and ionomycin. Using two colour cytokine staining, we showed that many individual CD4+ T cells produced IFNgamma along with either IL-4 or IL-13. Purified CD4+ T cells completely inhibited the outgrowth of autologous LCL in five out of nine cases, and partially inhibited outgrowth in the remaining four. There was no correlation between the pattern of CD4+ T-cell cytokine production and the capacity to inhibit outgrowth of autologous LCL. The killing of LCLs was contact-dependant and not mediated by soluble factors. We conclude that the ability of CD4+ T cells to inhibit autologous LCL growth is not directly related to T-helper cell cytokine production, but may depend on cytoxicity through surface ligands such as CD95L (FasL) and TNFalpha-related apoptosis-inducing ligand (TRAIL).

Variations in the compressive strength of dental cements stored in ionic or acidic solutions

The compressive strengths of various dental cements (a zinc polycarboxylate, a zinc phosphate, a glass-ionomer and two resin-modified glass ionomers, RMGICs) have been determined following storage in pure water, 0.9% sodium chloride solution or 20 mmol dm(-3) lactic acid solution for periods of time ranging from 24 h to 3 months. The glass-ionomer cement showed no differences between different storage solutions or at different storage times, whereas the zinc polycarboxylate, zinc phosphate and the resin-modified glass ionomer cements showed significant differences following storage in the solutions for 24 h compared with pure water. The zinc polycarboxylate cement was significantly weaker at 24 h in 0.9% NaCl and lactic acid than in pure water, whereas most of the other cements were significantly stronger in both 0.9% NaCl and lactic acid. One of the RMGICs (Vitremer luting, ex. 3M), however, was significantly stronger only in the NaCl solution, not in the lactic acid. In general, by 1 week, the strengths all reverted to being essentially the same as for specimens stored in pure water for most subsequent storage times, and did not change significantly on storage for up to 3 months. This effect of storage medium on the early strength has not been reported previously and since the media were chosen to model certain characteristics of natural saliva, the changes observed seem likely to occur in vivo. It is concluded that pure water is not the best medium for storing these cements if they are to behave as they do under clinical conditions.

The effect of storage in aqueous solutions on glass-ionomer and zinc polycarboxylate dental cements

Cylindrical specimens (dimensions 6 mm diameter x 12 mm height) of glass-ionomer and of zinc polycarboxylate dental cement have been stored in aqueous solutions for periods of 24 h, 1 week and 1 month. The solutions were of varying composition and affinity for water, and storage in them resulted in fluctuations in mass of the cements, an effect which was attributed to differences in the partitioning of water between the solutions and the cement specimens. Unlike the zinc polycarboxylate, the glass-ionomer gained mass in most of the solutions examined (except Na(2)SO(4)), showing it to have a much greater affinity for water than the zinc polycarboxylate. Despite the fluctuations in water uptake by the glass-ionomer, and loss of water by the zinc polycarboxylate, no statistically significant differences in compressive strength were recorded in any solution at any storage time. This contrasts with results reported previously for zinc polycarboxylates using smaller specimens, showing that specimen size has an influence on the interaction of cements with storage solutions.

The major Epstein-Barr virus (EBV) envelope glycoprotein gp340 when incorporated into Iscoms primes cytotoxic T-cell responses directed against EBV lymphoblastoid cell lines

A recombinant form of the EBV envelope glycoprotein and vaccine candidate gp340, lacking its hydrophobic transmembrane region, was incorporated into Iscoms after coupling to phosphatidyl ethanolamine via carbohydrate residues. Coupling by partial oxidation of gp340 carbohydrate with sodium periodate partly denatured the incorporated gp340 as indicated by its reduced reactivity with monoclonal antibodies that recognise the major neutralising epitope. Immunisation of cottontop tamarins with these Iscoms elicited antibody responses to gp340, but these antibodies only poorly recognised the major neutralising epitope in a competition ELISA and were unable to neutralise EBV in vitro. Despite the lack of neutralising antibody, immunisation with these Iscoms primed significant in vitro proliferative responses to soluble gp340 in lymphocytes from the draining lymph nodes and spleen. T-cell lines were raised from both immunised and control animals by in vitro stimulation of peripheral blood lymphocytes or spleen cells with autologous EBV-transformed lymphoblastoid cell lines. The T-cell lines from control animals had higher numbers of CD4+ T-cells than CD8+ T-cells and were not cytotoxic for autologous lymphoblastoid cell lines (LCL). In contrast the lines from immunised animals contained more CD8+ T-cells than CD4+ T-cells and had marked cytotoxicity for autologous LCL.

Results of three to 10 year follow up of balloon dilatation of the pulmonary valve

BACKGROUND

The results of immediate and short term follow up of balloon dilatation of the pulmonary valve have been well documented, but there is limited information on long term follow up.

OBJECTIVE

To evaluate the results of three to 10 year follow up of balloon dilatation of the pulmonary valve in children and adolescents.

SETTING

Tertiary care centre/university hospital.

DESIGN

Retrospective study.

METHODS AND RESULTS

85 patients (aged between 1 day and 20 years, mean (SD) 7.0 (6.4) years) underwent balloon dilatation of the pulmonary valve during an 11 year period ending August 1994. There was a resultant reduction in the peak to peak gradient from 87 (38) to 26 (22) mm Hg. Immediate surgical intervention was not required. Residual gradients of 29 (17) mm Hg were measured by catheterisation (n = 47) and echo Doppler (n = 82) at intermediate term follow up (two years). When individual results were scrutinised, nine of 82 patients had restenosis, defined as a peak gradient of 50 mm Hg or more. Seven of these patients underwent repeat balloon dilatation of the pulmonary valve: peak gradients were reduced from 89 (40) to 38 (20) mm Hg. Clinical evaluation and echo Doppler data of 80 patients showed that residual peak instantaneous Doppler gradients were 17 (15) mm Hg at long term follow up (three to 10 years, median seven), with evidence for late restenosis in one patient (1.3%). Surgical intervention was necessary to relieve fixed infundibular stenosis in three patients and supravalvar pulmonary stenosis in one. Repeat balloon dilatation was performed to relieve restenosis in two patients. Actuarial reintervention free rates at one, two, five, and 10 years were 94%, 89%, 88%, and 84%, respectively. Pulmonary valve regurgitation was noted in 70 of 80 patients at late follow up, but neither right ventricular dilatation nor paradoxical interventricular septal motion developed.

CONCLUSIONS

The results of late follow up of balloon dilatation of the pulmonary valve are excellent. Repeat balloon dilatation was performed in 11% of patients and surgical intervention for subvalvlar or supravalvar stenosis in 5%. Most patients had mild residual pulmonary regurgitation but right ventricular volume overload was not required. Balloon dilatation is the treatment of choice in the management of moderate to severe stenosis of the pulmonary valve. Further follow up studies should be undertaken to evaluate the significance of residual pulmonary regurgitation.