Evaluation of novel protease enzymes on growth performance and nutrient digestibility of poultry: enzyme dose response

Two experiments were conducted to evaluate 3 novel proteases in broilers. In experiment 1, 600 male, Cobb 500 broilers were allocated to 1 of 12 experimental diets (5 birds/pen and 10 replicates/diet). A control (C) diet was formulated to be adequate in all nutrients. Proteases 1, 2, or 3 were added to this diet at 3 doses (1x, 3x, or 9x) in a 3 × 3 factorial arrangement of treatments. The factorial was augmented with 2 treatments of phytase at 500 or 1,500 FTU/kg added to the C diet. In experiment 2, 2,050 male Ross 308 broilers were allocated to 1 of 10 experimental diets (25 birds/pen and 9 replicates/diet). A C diet was formulated to be adequate in all nutrients. Protease 1, 2, or 3 was then added to the C diet at 3 doses (1x, 2x, or 4x) in a 3 × 3 factorial arrangement of treatments plus the C. In experiment 1, birds fed phytase gained more (P < 0.05) than birds fed protease, but neither were different than birds fed the C. Supplementation of 9x dose of any protease resulted in a reduction (P < 0.05) in BWG when compared with birds fed 1x dose of protease or phytase at 500 or 1,500 FTU/kg. Feed conversion ratio was improved (P < 0.05) in birds fed phytase compared with birds fed the C diet. Nitrogen digestibility was greater (P < 0.05) in birds fed protease 1 when compared with birds fed protease 2. Birds fed the 1x dose of protease or 500 FTU/kg of phytase had a greater (P < 0.05) N digestibility than birds fed 3x dose of protease. In experiment 2, protease supplementation significantly reduced (P < 0.05) BWG when compared with birds fed the C from hatch to 35 D post-hatch. Protease supplementation did not improve broiler growth performance or N digestibility above that of a nutrient adequate control diet or a diet supplemented with 500 FTU/kg of phytase.

Phylogenetic Variation of Chelonid Alphaherpesvirus 5 (ChHV5) in Populations of Green Turtles Chelonia mydas along the Queensland Coast, Australia

Sea turtle fibropapillomatosis (FP) is a disease marked by the proliferation of benign but debilitating cutaneous and occasional visceral tumors, likely to be caused by chelonid alphaherpesvirus 5 (ChHV5). This study presents a phylogeny of ChHV5 strains found on the east coast of Queensland, Australia, and a validation for previously unused primers. Two different primer sets (gB-1534 and gB-813) were designed to target a region including part of the UL27 glycoprotein B (gB) gene and part of UL28 of ChHV5. Sequences obtained from FP tumors found on juvenile green turtles Chelonia mydas (<65 cm curved carapace length) had substantial homology with published ChHV5 sequences, while a skin biopsy from a turtle without FP failed to react in the PCRs used in this study. The resulting sequences were used to generate a neighbor-joining tree from which three clusters of ChHV5 from Australian waters were identified: north Australian, north Queensland, and Queensland clusters. The clusters reflect the collection sites on the east coast of Queensland with a definitive north-south trend. Received October 22, 2016; accepted May 7, 2017.

Functional and structural characterization of the insertion region in the ligand binding domain of the vitamin D nuclear receptor

Vitamin D nuclear receptor mediates the genomic actions of the active form of vitamin D, 1,25(OH)2D3. This hormone is involved in calcium and phosphate metabolism and cell differentiation. Compared to other nuclear receptors, VDR presents a large insertion region at the N-terminal part of the ligand binding domain between helices H1 and H3, encoded by an additional exon. This region is poorly conserved in VDR in different species and is not well ordered as observed by secondary structure prediction. We engineered a VDR ligand binding domain mutant by removing this insertion region. Here we report its biochemical and biophysical characterization. The mutant protein exhibits the same ligand binding, dimerization with retinoid X receptor and transactivation properties as the wild-type VDR, suggesting that the insertion region does not affect these main functions. Solution studies by small angle X-ray scattering shows that the conformation in solution of the VDR mutant is similar to that observed in the crystal and that the insertion region in the VDR wild-type is not well ordered.

Similar responses in hemostatic factors after consumption of wholemeal rye bread and low-fiber wheat bread

OBJECTIVE

Both epidemiological and experimental evidence suggests a protective effect of dietary fiber against disease, such as cancer and cardiovascular disease. The effects of fiber on lipoproteins are modest, indicating that other mechanisms may be involved. As the hemostatic effects of different types of fiber are poorly known, we compared the effects of wholemeal rye bread and low-fiber wheat bread on factors related to coagulation, fibrinolysis and platelet function.

DESIGN

Subjects consumed rye and wheat bread as part of their habitual diet in a cross-over manner for 4 weeks, with a 4 week washout period between the diet periods.

SUBJECTS

Forty healthy subjects (18 men, 22 women), aged 43+/-2 y.

RESULTS

Mean daily intake of fiber during the rye bread period was 31 g for men and 26 g for women, while the respective figures for the wheat bread period were 15 g and 12 g. However, no significant differences between the two periods were seen in factor VII coagulant activity (FVIIc), fibrinogen, prothrombin fragments 1+2 (F1+2), tissue plasminogen activator (tPA) plasminogen activator inhibitor 1 (PAI-1) or 2,3,-dinor-thromboxane B2. Fibrin degradation products, D-dimers, were slightly lower after the wheat period (P=0.046).

CONCLUSIONS

The results indicate that wheat and rye bread do not differ in their effects on coagulation, fibrinolysis or platelet function.

SPONSORSHIP

Fazer Bakeries Ltd, Lahti Finland; Vaasan & Vaasan Ltd, Helsinki, Finland.

Large-scale expression and purification of the human vitamin D receptor and its ligand-binding domain for structural studies

We have expressed recombinant human vitamin D receptor and its ligand-binding domain in Spodoptera frugiperda (Sf9) insect cells with a 30-litre bioreactor. Both proteins were purified to apparent homogeneity with yields of 0.5-3.5 mg/l. Gel-filtration analyses indicated that the purified human vitamin D receptor and its ligand-binding domain were present as monomers in solution. The purified vitamin D receptor and its ligand-binding domain were demonstrated to bind 1alpha,25-dihydroxyvitamin D(3) with high affinity, the K(d) values ranging from 0.9 to 1.2 nM. Neutron scattering studies of the ligand-binding domain demonstrated that the samples are homogeneous and contain monomeric species of polypeptides. The purified vitamin D receptor binds to the vitamin D response elements of osteopontin and osteocalcin genes as a homodimer or as a heterodimer with the retinoid X receptor-alphaDeltaAB and we were able to purify these complexes in quantities sufficient for crystallization studies. The results indicate that we can produce biologically active human vitamin D receptor and its ligand-binding domain in insect cells and purify them for functional and structural studies.

The clinical outcome in pregnancies of grand grand multiparous women

OBJECTIVE

To longitudinally evaluate maternal and neonatal complications with relation to birth order, with specific emphasis on grand grand multiparity (at least 10th para).

METHODS

The maternal and neonatal outcome of 1200 pregnancies/deliveries in 96 grand grand multiparas was longitudinally investigated in 4 stages of the mothers' life: the primiparas, the multiparas (2nd-5th paras), the grand multiparas (6th-9th paras) and the grand grand multiparas stage.

RESULTS

The frequency of hypertension, diabetes, placental complications, operative interventions at delivery, macrosomic infants, chromosomal abbreviations and fetal/neonatal anomalies increased with increasing birth order, being at a maximum in grand grand multiparas. The preterm delivery and perinatal mortality rate did not differ between the 3 groups of multiparas. Perinatal outcome was good in each group.

CONCLUSIONS

Grand grand multiparity carries the risk of hypertensive and diabetic complications, which, in turn, often lead to induced or operative deliveries and placental complications. However, grand grand multiparity is not a major problem in societies with a good maternal health care system.

Conformational studies of human vitamin-D receptor by antipeptide antibodies, partial proteolytic digestion and ligand binding

We have studied conformational changes of human vitamin-D receptor by using antipeptide antibodies, partial proteolytic digestion and binding of the natural ligand calcitriol or its synthetic analogs. Before exposing either [35S]methionine-labelled in vitro translated human vitamin-D receptor or a recombinant human vitamin-D receptor produced either in Escherichia coli or in Sf9 insect cells to limited proteolysis by trypsin or chymotrypsin, the proteins were treated with calcitriol or its synthetic analogs. The digestion products were analyzed by SDS/PAGE, immunoblotting with polyclonal antipeptide antibodies targeted against different domains of the receptor, and Edman N-terminal sequencing. After limited proteolysis with trypsin, two fragments of Mr 21,000 and Mr 34,000 could be localized into N-terminus and C-terminus of the receptor, respectively, by antipeptide antibodies. We found that treatment with calcitriol or its synthetic analogs leads to differential resistance of the ligand-binding domain of the recombinant receptor to partial proteolysis in vitro. We suggest that this is due to distinct conformational changes in the domain induced by the different ligands. The short N-terminal region and the Zn-finger domain form, however, a protease-resistant structure which is independent on the presence or absence of the ligand. When the C-terminal fragment of Mr 34,000 was further analyzed by Edman N-terminal sequencing, the major cleavage site in the receptor between amino acids Arg173 and His174 was revealed.

Long gonadotrophin releasing hormone agonist/human menopausal gonadotrophin protocol for ovarian stimulation in intrauterine insemination treatment

OBJECTIVE

This prospective study was undertaken to examine the usefulness of a long gonadotrophin releasing hormone agonist (GnRH-a)/human menopausal gonadotrophin (hMG) protocol in intrauterine insemination (IUI) treatment. The results were compared to those of clomiphene citrate (CC)/hMG/IUI.

STUDY DESIGN

Seventy-five patients were recruited to a GnRH-a/hMG group (group 1) while 88 patients underwent CC/hMG stimulation and served as controls (group 2). The study subjects were stimulated with a long GnRH-a/hMG regimen. IUI was performed 36 h after the administration of human chorionic gonadotrophin.

RESULTS

The number of preovulatory follicles, the thickness of endometrium and sperm parameters were similar in both groups. The hMG requirements were significantly higher in group 1 than in group 2 (21.2 +/- 5.1 vs. 8.1 +/- 3.1 ampoules). The pregnancy rate was 20% in group 1 and 12.5% in group 2, the difference being not significant.

CONCLUSION

The pregnancy rates were not significantly different between the GnRH-a/hMG/ IUI and CC/hMG/IUI groups. In addition, GnRH-a/hMG stimulation is notably more expensive than CC/hMG, and for these reasons, GnRH-a/hMG stimulation is not cost-effective in routine IUI therapy.

Comparison of fallopian tube sperm perfusion with intrauterine insemination in the treatment of infertility

OBJECTIVE

To compare the efficacy of fallopian tube sperm perfusion utilizing a Foley catheter technique with standard IUI.

DESIGN

Randomized controlled study.

SETTING

The infertility units of the University Central Hospital and the Family Federation of Finland, Oulu, Finland.

PATIENT(S)

One hundred infertile women with unexplained factor, minimal to mild endometriosis, mild male factor, or ovarian dysfunction, undergoing 50 IUI and 50 fallopian tube sperm perfusion cycles stimulated by clomiphene citrate and hMG.

INTERVENTION(S)

Thirty-six hours after hCG administration, patients were randomized to either the IUI group (group 1, 50 patients and cycles) or the fallopian tube sperm perfusion group (group 2, 50 patients and cycles). Intrauterine insemination was performed using a standard method and fallopian tube sperm perfusion with a pediatric Foley catheter, which prevents the reflux of sperm suspension.

MAIN OUTCOME MEASURE(S)

Number of clinical pregnancies.

RESULTS(S)

The fallopian tube sperm perfusion method using a Foley catheter technique was easy to perform and convenient for the patients. The overall pregnancy rate per cycle was 8% for fallopian tube sperm perfusion and 20% for IUI, a difference that was not significant.

CONCLUSION(S)

The fallopian tube sperm perfusion method using a Foley catheter offers no advantage in comparison with the conventional IUI technique.

Is varicocele treatment useful?

The effect of the treatment of varicocele on symptoms and fertility was followed up in 66 patients for an average of 27 months (range 6-84 months). The patients had been treated either surgically (n = 45) or with embolization (n = 21). The mean duration of the inpatient periods and sick leaves were significantly shorter among the patients treated with embolization than among the surgical patients (2.4 vs 3.3 days and 4.8 vs 21.3 days, respectively). Scrotal problems disappeared either completely or almost completely in 73% of the patients treated for symptoms (n = 40). The number of spermatozoa increased significantly (from 6.7 mill/ml to 27.4 mill/ml) in the patients with infertility after the treatment of varicocele. Pregnancy started in 31% of the couples with infertility problems. A spontaneous abortion occurred in two cases, and six couples (23%) had a child of their own. It could be concluded that the treatment of varicocele is useful regardless of whether it is given for symptoms or infertility. It is also indicated for the patients with infertility problems who have a low number of spermatozoa and disturbed spermatozoan motility in sperm analysis.

Clinical features of primary ovarian failure caused by a point mutation in the follicle-stimulating hormone receptor gene

The recent finding that a mutation in the FSH receptor gene causes ovarian dysgenesis prompted the present study to determine the phenotype caused by this mutation. Twenty-two patients with ovarian dysgenesis and a 566C-->T mutation in the FSH receptor gene (designated FSH-resistant ovaries or FSHRO) were compared with 30 clinically similar patients with ovarian dysgenesis (designated ODG) who did not have this mutation. The genealogical studies suggested a founder effect of the FSH receptor gene mutation in Finland. Clinically, both groups of patients were characterized by primary or early secondary amenorrhea, variable development of secondary sex characteristics, and high serum levels of FSH and LH. Notable differences were observed in median adult height (FSHRO patients were shorter) and the occurrence of follicles judged by transvaginal sonography (observed in 6 of 8 FSHRO vs. 1 of 11 ODG) and ovarian histology (present in all 9 FSHRO vs. 1 of 4 ODG). These findings suggest that a subset of ovarian dysgenesis patients with the FSH receptor mutation 566C-->T is pathogenetically distinct, possibly due to residual receptor activity, and that these patients can be tentatively identified by demonstrating the presence of ovarian follicles and confirmed by mutation analysis.

Oligosaccharide constructs with defined structures that inhibit binding of mouse sperm to unfertilized eggs in vitro

During fertilization in mice, free-swimming sperm bind to mZP3, an 83-kDa glycoprotein present in the egg extracellular coat, the zona pellucida [Wassarman, P. M. (1990) Development 108, 1-17]. Mouse sperm recognize and bind to a specific class of serine/threonine-linked (O-linked) oligosaccharides present on mZP3. After binding to mZP3, sperm undergo a form of cellular exocytosis, the acrosome reaction, thereby enabling them to penetrate the zona pellucida and fertilize the egg. Thus, gamete interactions in mice are carbohydrate-mediated. In this context, we tested 15 O-linked-related oligosaccharide constructs with defined structures for their ability to inhibit binding of mouse sperm to ovulated eggs and to induce sperm to undergo the acrosome reaction in vitro. Thirteen of the oligosaccharides were constructed and characterized in our laboratory [Seppo, A., Pentillä, L., Niemelä, R., Maaheimo, H., Renkonen, O., & Keane, A. (1995) Biochemistry 34, 4655-4661]; two were obtained commercially. We found that, while none of the oligosaccharides induced sperm to undergo the acrosome reaction, a few of them inhibited binding of sperm to eggs at relatively low concentrations (ID50 < 5 microM). In certain cases, sperm formed head-to-head aggregates in the presence of the oligosaccharides. The results suggest that the ability of oligosaccharides to inhibit binding of sperm to eggs is dependent on several parameters, including the size and branching pattern of the oligosaccharide, as well as on the nature of the sugar residue at the nonreducing end of the oligosaccharide.

Intrafollicular insemination for the treatment of infertility

The effectiveness of intrafollicular insemination (IFI) for the treatment of non-tubal infertility was investigated in a pilot study. A total of 50 infertility patients with normal tubal function verified by laparoscopy or hysterosalpingography were stimulated with clomiphene citrate/human menopausal gonadotrophin. Washed spermatozoa were injected into one to three pre-ovulatory follicles via vaginal puncture 12 or 30 h after human chorionic gonadotrophin administration. Natural progesterone was given for luteal support. The IFI procedure was technically very simple and convenient for the patient and no complications were recorded. One normal intra-uterine pregnancy resulted. The results indicate that by comparsion with other assisted reproductive technologies IFI is very inefficacious for treating non-tubal infertility. Our data suggest that the intrafollicular environment in the preovulatory period is not favourable for fertilization.

Natural interpregnancy intervals of fertile couples: a longitudinal survey of grand grand multiparous women

OBJECTIVE

To characterize the natural fecundity of grand grand multiparous women (> or = 10 deliveries) in relation to age, number of pregnancies, body mass index, and chronic diseases.

DESIGN

A retrospective longitudinal analysis of interpregnancy intervals of married couples who had never used any kind of contraception.

PATIENTS, PARTICIPANTS

The interpregnancy intervals (months from delivery or spontaneous abortion to the next conception) of 96 grand grand multiparous women with a total of 1,327 pregnancies were evaluated from the first to the latest pregnancy (14 +/- 1.7; mean +/- SD). Because of the lack of reliable data on conception times, 109 pregnancies had to be excluded. The number of interpregnancy intervals remaining for evaluation was thus 1,218.

RESULTS

The mean interpregnancy intervals in the material of 1,218 pregnancies was 8.5 +/- 4.9 months, being significantly shorter after an abortion (5.3 +/- 4.8 months) or stillbirth (6.0 +/- 4.7 months) than after a delivery (8.9 +/- 5.6 months). The interpregnancy interval was significantly longer in women over 30 years of age than in the younger women, approximately 7 months in the latter and exceeding 10 months around the age of 40 years. Body mass index and chronic medical illness did not influence the interpregnancy intervals. The incidence of spontaneous abortions increased after the age of 30 years. It was 6% until 30 years, 10% between 31 and 35 years, and 25% after 40 years.

CONCLUSIONS

In this retrospective longitudinal review, the reproductive capacity of fertile couples remains rather sound until premenopausal age. The data suggest that a woman's delivery capacity could be 25 births between 16 and 45 years of age.

Partogram of a grand multipara: different descent slope compared with an ordinary parturient

Partograms of 42 grand multipara women (mean 10 previous deliveries) were analyzed and compared with the partograms of nulli- or second-/thirdpara women. All these full-term pregnancies were normal and the vaginal deliveries were spontaneous and non-instrumental. The grand multiparas had the shortest duration of the latent phase and the second stage of the delivery, but the active slope of the cervical dilation was in all groups same, on the average 2.8 cm/hour. The station of the presenting part of the fetus remained in the grand multipara group significantly higher than in the other parturients for the whole first stage of labor. During this delayed descent the normal rotation of the fetal head from occiput transverse to occiput anterior position was delayed and fetuses were often delivered in a low transverse head position. The cephalopelvic disproportion need not be the most obvious reason for a slow descent in a grand multipara delivery, but slow descent can be caused by the physiological changes due to the great number of previous pregnancies.

Subcutaneous goserelin versus intranasal buserelin for pituitary down-regulation in patients undergoing IVF: a randomized comparative study

One-hundred women undergoing ovarian stimulation with gonadotrophin-releasing hormone agonist (GnRH-a) and a human menopausal gonadotrophin (HMG) for in-vitro fertilization (IVF) participated in this randomized comparative study. The effectiveness of long-acting s.c. goserelin (Zoladex depot; 49 patients) and intranasally (i.n.) administered buserelin acetate (Suprefact; 51 patients) for pituitary down-regulation was compared. Treatment with s.c. goserelin (3.6 mg) or i.n. buserelin acetate (200 micrograms; 6 times/day) was started on day 21-23 of the cycle. Stimulation with 150 IU of HMG/day was started after at least 11 days of GnRH-a treatment. There were no differences in the time required for follicular development nor in the clinical outcome between groups treated with either goserelin or buserelin. The number of oocytes recovered in the goserelin group was 6.7 +/- 5.0 versus 6.3 +/- 4.9 in the buserelin group. There were 11 pregnancies after the use of goserelin (22.4%) and 12 pregnancies in those given buserelin (24.0%). The number of HMG ampoules needed for follicular maturation was higher in the goserelin group (27.9 +/- 7.8) than in the buserelin group (24.6 +/- 7.8, P < 0.05). The patients given buserelin suffered significantly more from tiredness, depression, headache and abdominal pain than those receiving goserelin, whereas there were no differences between the groups in experiencing mental irritability, nausea and swelling. Subcutaneous goserelin depot injection offers a useful alternative for pituitary down-regulation in IVF stimulation.

A new application of a screw-plate for prosthetic reconstruction after bilateral total maxillectomy

Satisfactory functional and aesthetic rehabilitation of a patient after total bilateral maxillectomy is a great challenge to the surgeon and prosthodontist. A particular problem is support and retention of the obturator. In the case described, the problem was solved by attaching the prosthesis with finger clasps to a classic AO-reconstruction plate anchored rigidly with screws to both zygomata. The results in terms of mastication, swallowing, phonation and aesthetics were satisfactory for more than 2 years, when the patient died from brain metastasis and pneumonia. The technique seems promising and merits further study using titanium screws and plates.

Urticaria in children. Retrospective evaluation and follow-up

A retrospective study supplemented with follow-up was carried out in 163 children, aged 6 months to 16 years, who were hospitalized because of acute, recurrent or chronic urticaria in 1976-1980. Etiologic agents were identified in 55% of cases. Physical factors were the commonest causes, especially in cases of chronic urticaria, while infections predominated in acute urticaria. 81% of the children participated in the follow-up study. Follow-up for a year or more revealed that 53% of the children had become symptom-free, 36% still had symptoms but less frequently and in 11% urticaria was unresolved. The results indicate that the etiologic factors in childhood urticaria are similar to those found in adults and that prognosis is favorable, particularly when the etiology is established.

Do infections in infancy affect sensitization to airborne allergens and development of atopic disease? A retrospective study of seven-year-old children

We studied 145 children aged 7 years, who had been at day-care centers for at least 3 months during the 2 first years of their lives. The group was compared with a matched population of 145 children cared for at home. Of the 290 children, 212 participated in all phases of the study, which included a questionnaire to parents, skin prick tests with seven allergens, and a clinical examination. Day-care-center children had twice as much otitis media in infancy as "home" children (P less than 0.001), and they also tended to have more other infections. On the other hand, day-care-center children did not have more eczema in infancy, more cumulated atopic disease by the age of seven, or more positive skin tests than home children. When the groups were combined, an increased prevalence of cumulated atopic disease and positive skin tests was found in children with infections in infancy. We conclude that under the conditions of this study infections in infancy did not facilitate the development of hypersensitivity to allergens and atopic disease. The linked tendencies to develop infections and atopy could depend on some third factor.

Caldwell-Luc operation in the treatment of childhood bronchial asthma

A follow-up study was carried out in 15 children with severe bronchial asthma. Chronic infection of the paranasal sinuses was connected with the unfavorable course of their bronchial asthma. As adenoidectomy and intranasal antrostomy had failed to cure the sinusitis, the Caldwell-Luc operation was performed at the age of 6-16 years. The follow-up examination was done 3-12 years after the radical operation of the maxillary sinuses. The majority of the patients had normal working capacity, and the need of medical treatment was reasonable. It is concluded that the Caldwell-Luc operation is indicated in children with severe bronchial asthma, when repeated respiratory infections are associated with asthmatic attacks and adenoidectomy and intranasal antrostomy have proved ineffective.

Immunoglobulin E and immunoglobulin G4 antibodies to cow's milk in children with cow's milk allergy

The presence of cow's milk specific antibodies of immunoglobulin E and G4 classes were studied in 47 children with a positive clinical history of cow's milk allergy. The children were challenged with cow's milk orally. The clinical diagnosis was verified by immediate reactions in 25 patients while 22 had late reactions or were provocation test negative in spite of the clinical history. There was no relation between levels of cow's milk specific IgG4 antibodies and provocation test results, i.e. neither with immediate or late reactions. Total IgE was elevated above +1 SD for age in 31 of 41 tested patients. Of these, 29 had immediate type reactions to cow's milk, wheat flour and/or egg white, while only two of 10 children with IgE of less than +1 SD had a demonstrable allergy to any of these foods. The sensitivity of the total IgE determinations for the diagnosis of food allergy was 94% and the specificity was 80%. Specific IgE antibodies to cow's milk were demonstrated in 11 of 14 children with immediate reactions and in three of 15 who were provocation test negative or had only late reactions. This means a sensitivity of 79% and a specificity of 80%. At least one of the four patients with specific IgE but negative provocation test results had earlier shown an immediate reaction when challenged with cow's milk, indicating that the specific IgE antibodies were not truly "false" positive reactions but a consequence of previous allergy. Our results confirm an association between elevated total serum IgE and food allergy and an association between positive RAST to cow's milk and positive provocations in young children. We did not find any evidence for specific IgG4 antibodies playing a role in these patients.

Serum immunoglobulin E in atopic and non-atopic children aged 6 months to 5 years. A follow-up study

In order to obtain serum IgE reference values for small children we measured the total serum IgE concentration at the ages of 6 months, 1, 3, and 5 years in 66 healthy, non-atopic children who were followed from birth to 5 years of age. From this reference group we had excluded children with symptoms or signs of atopy during the follow-up period, as well as children with blood or nasal smear eosinophilia or positive skin prick tests. We also studied serum IgE levels in groups of children having latent atopy, symptomatic atopy, or severe atopic disease. We suggest that in the definition of reference values the upper limit of normal should be replaced by a zone of uncertainty, lying between the 95th and 97.5th percentiles. Serum IgE is a useful test with high specificity but low sensitivity in the differentiation between atopy and non-atopy. Thus high levels suggest atopy, while normal or low values yield little information. A normal serum IgE level does not necessarily exclude atopic disease.

Studies of monoclonal and polyclonal anti-digoxin antibodies for serum digoxin radioimmunoassay

We compared the advantages of monoclonal antibodies (produced by plasma cell-myeloma cell hybrid lines) and those of conventional antibodies in the radioimmunoassay of digoxin. It was found that antibodies produced by some hybrid cell lines (hybridomas) were highly specific for the digoxin structure; this way the cross-reactions to related structures (e.g. spironolactone) could be avoided. When the hybridoma lines were grown in ascites, the resulting fluid could have as high or higher titre than the serum of a hyperimmunized rabbit. The high titre, the specificity and the permanent growth of the hybridoma lines make them an optimal source of the specific antibody in clinical radioimmunoassays for the measurement of drug or hormone levels.

Cry analysis in infants with severe malnutrition

Sound spectrographic investigations of the cries of 5 infants, age 7 m to 2 y, with severe malnutrition (one with kwashiorkor and four with marasmus) were compared with the cries of 15 healthy children of corresponding age. The cry of the child with kwashiorkor resembled those of the normal infants. The cries of the marasmic children showed a significant increase in the minimum and maximum pitch, and the occurrence of biphonation and flat melody types. These features have also been found in the cries of children with brain damage. We therefore believe that cry and analysis can be an additional means of investigating to what degree the brain is affected in children with malnutrition.