An Australian twin study of the genetic basis of preeclampsia and eclampsia

OBJECTIVE: We investigated maternal versus fetal genetic causes of preeclampsia and eclampsia by assessing concordance between monozygotic and dizygotic female co-twins, between female partners of male monozygotic and dizygotic twin pairs, and between female twins and partners of their male co-twins in dizygotic opposite-sex pairs. STUDY DESIGN: Two large birth cohorts of volunteer Australian female twin pairs (N = 1504 pairs and N = 858 pairs) were screened and interviewed, and available medical and hospital records were obtained and reviewed where indicated, with diagnoses assigned according to predetermined criteria. RESULTS: With strict diagnostic criteria used for preeclampsia and eclampsia, no concordant female twin pairs were found. Collapsing diagnoses of definite, probable, or possible preeclampsia or eclampsia resulted in very low genetic recurrence risk estimates. CONCLUSION: Results from these two cohorts of female twin pairs do not support clear, solely maternal genetic influences on preeclampsia and eclampsia. Numbers of parous female partners of male twins were too low for conclusions to be drawn regarding paternal transmission.

Opportunities for the control of coronary heart disease in Australia

Objective: To estimate the number of coronary events that could be prevented in Australia each year by the use of preventive and therapeutic strategies targeted to subgroups of the population based on their levels of risk and need. Methods: Estimates of risk reduction from the published literature, prevalence estimates of elevated risk factor levels from the 1995 National Health Survey and treatment levels from the Australian collaborating centres in the World Health Organization's MONICA Project were used to calculate numbers of coronary events preventable among men and women aged 35-79 years in Australia. Results: Approximately 14,000 coronary events could be avoided each year if the mean level of cholesterol in the population was reduced by 0.5 mmol/L, smoking prevalence was halved and prevalence of physical inactivity was reduced to 25%. This represents a reduction in coronary events of about 40%. Even with less optimistic targets, a reduction of 20% could be attained, while the achievement of some internationally recommended targets could lead to almost 50% reduction. In the short term, aggressive medical treatment of people with elevated levels of risk factors and established coronary disease offers the greatest opportunity for reducing coronary events. Conclusion: A comprehensive approach to reduce levels of behavioural and biological risk factors and improve the use of effective treatment could lead to a large reduction in coronary event rates. In the long term, primary prevention - especially to reduce smoking, lower cholesterol levels and increase exercise - has the potential to reduce the population levels of risk and hence contain the national cost of coronary disease.

Heritability and gene-environment interactions for melanocytic nevus density examined in a U.K. adolescent twin study

Risk factors for melanoma include environmental (particularly ultraviolet exposure) and genetic factors. In rare families, susceptibility to melanoma is determined by high penetrance mutations in the genes CDKN2A or CDK4, with more common, less penetrant genes also postulated. A further, potent risk factor for melanoma is the presence of large numbers of melanocytic nevi so that genes controlling nevus phenotype could be such melanoma susceptibility genes. A large Australian study involving twins aged 12 y of predominantly U.K. ancestry showed strong evidence for genetic influence on nevus number and density. We carried out essentially the same study in the U.K. to gain insight into gene-environment interactions for nevi. One hundred and three monozygous (MZ) and 118 dizygous (DZ) twin pairs aged 10-18 y were examined in Yorkshire and Surrey, U.K. Nevus counts were, on average, higher in boys (mean = 98.6) than girls (83.8) (p = 0.009) and higher in Australia (110.4) than in the U.K. (79.2, adjusted to age 12 y, p < 0.0001), and nevus densities were higher on sun-exposed sites (92 per m(2)) than sun-protected sites (58 per m(2)) (p < 0.0001). Correlations in sex and age adjusted nevus density were higher in MZ pairs (0.94, 95% CI 0.92-0.96) than in DZ pairs (0.61, 95%CI 0.49-0.72), were notably similar to those of the Australian study (MZ = 0.94, DZ = 0.60), and were consistent with high heritability (65% in the U.K., 68% in Australia). We conclude that emergence of nevi in adolescents is under strong genetic control, whereas environmental exposures affect the mean number of nevi.

Association of Streptococcus mutans Infection and Oral Developmental Nodules in Pre-dentate Infants

Since dental caries may present soon after tooth eruption, we hypothesized that colonization of Streptococcus mutans can occur in the predentate stages. In this study, we examined S. mutans colonization and its association with oral developmental nodules (Bohn's nodules) in 60 pre-term and 128 full-term, three-month-old infants. Overall, S. mutans was cultured from 30% (56/188) of the infants, and oral developmental nodules were noted in 55% (103/188). Compared with the pre-term, full-term infants showed a higher prevalence of S. mutans (34% vs. 20%, p < 0.02) as well as developmental nodules (61% vs. 42%, p < 0.05). In both groups, S. mutans was positively associated with numbers of developmental nodules in a dose-response relationship (p < 0,001), and with maternal salivary levels of the bacteria (p = 0.03). The permanence of S. mutans infection was confirmed by repeat saliva sampling at 6 months of age. Our results thus showed that many infants have already acquired S. mutans at 3 months of age, prior to tooth eruption.

Industrial relations decentralisation and the growth of 12-hour shifts in Australia

In the last two decades, increasing numbers of workplaces in Australia have introduced 12-hour shifts. This increase is due, in part, to government policies aimed at promoting labour flexibility. The purpose of this paper is to examine the cover afforded by the Workplace Relations Act 1996 and other industrial relations legislation in terms of shift-workers’ health and safety. Particular reference is made to the broader social, economic and political context surrounding the introduction and use of 12-hour shifts, as it is this context that shapes the constraints and opportunities facing employers and employees in the work arrangements they choose and how they are negotiated. We conclude that the current system of regulating industrial relations in Australia is largely outcome-focused and inadequate. The bargaining process receives little regulation in terms of considering how changes could affect health and safety in the workplace or how changes might affect individual workers. As a result, the increased introduction of unsafe shiftworking arrangements is a worrying, and likely, prospect.

Gastrointestinal worm infections. The prevalence and treatment in Australia

BACKGROUND:Intestinal worm (helminth) infections occur in a large proportion of the world's population, often constituting public health problems, and are occasionally encountered by practitioners in urban Australia. Prevalence levels in some remote Australian Aboriginal communities compare with those in developing countries. OBJECTIVE: To provide general practitioners with a brief outline of the most common human intestinal helminthiases, their usual clinical presentations and how they are diagnosed and managed. DISCUSSION: The pinworm, Enteroblus vermicularis, occurs in all populations, and is the most common species of nematode encountered in suburbia. Eradication is impossible, but its numbers can be kept low in those children who seem predisposed to heavy, symptomatic infections. The other nematodes are prevalent in some remote Australian Aboriginal communities, and are encountered occasionally in travellers from overseas. These infections are often asymptomatic, they cannot spread directly to other people and so do not pose any public health threat to the general community under suburban living conditions. The tapeworms are encountered even less frequently, except for Hymenolepis, the dwarf tapeworm, which is prevalent in some Aboriginal communities.

Predictors of non-response to a questionnaire survey of a volunteer twin panel: Findings from the Australian 1989 twin cohort

Questionnaire surveys, while more economical, typically achieve poorer response rates than interview surveys. We used data from a national volunteer cohort of young adult twins, who were scheduled for assessment by questionnaire in 1989 and by interview in 1996-2000, to identify predictors of questionnaire non-response. Out of a total of 8536 twins, 5058 completed the questionnaire survey (59% response rate), and 6255 completed a telephone interview survey conducted a decade later (73% response rate). Multinomial logit models were fitted to the interview data to identify socioeconomic, psychiatric and health behavior correlates of non-response in the earlier questionnaire survey. Male gender, education below University level, and being a dizygotic rather than monozygotic twin, all predicted reduced likelihood of participating in the questionnaire survey. Associations between questionnaire response status and psychiatric history and health behavior variables were modest, with history of alcohol dependence and childhood conduct disorder predicting decreased probability of returning a questionnaire, and history of smoking and heavy drinking more weakly associated with non-response. Body-mass index showed no association with questionnaire non-response. Despite a poor response rate to the self-report questionnaire survey, we found only limited sampling biases for most variables. While not appropriate for studies where socioeconomic variables are critical, it appears that survey by questionnaire, with questionnaire administration by telephone to non-responders, will represent a viable strategy for gene-mapping studies requiring that large numbers of relatives be screened.

Forced emigration, favourable outcomes

The discipline of public health and preventive medicine in Australia and New Zealand had its genesis in the advocacy of 18th and 19th century military pioneers. Military (Royal Navy and British Army) surgeons were posted to Australia as part of their non-discretionary duty. Civilian doctors emigrated variously for adventure, escapism and gold fever. One group, a particularly influential group disproportionate to their numbers, came in one sense as forced emigrants because of chronic respiratory disease in general, and tuberculosis in particular. Tuberculosis was an occupational hazard of 19th century medical and surgical practice throughout western Europe. This paper analyses six examples of such emigration which had, perhaps unforeseen at the time, significant results in the advancement of public health. Such emigration was in one sense voluntary, but in another was forced upon the victims in their quest for personal survival. In Australia, such medical individuals became leading advocates and successful catalysts for change in such diverse fields as social welfare, public health, the preventive aspects of medical practice, child health, nutrition and medical education. A number of such public health pioneers today have no physical memorials; but their influence is to be seen in the ethos of medical practice in Australia and New Zealand today. Their memory is further perpetuated in the names of Australian native wildflowers and trees that symbolise not only a healthy environment but the longterm investment, accrued with interest, of the institution of public health measures for which their advocacy achieved much success.

Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian population

Background, aim: The present study describes (i) the natural distribution of the three putative periodontopathogens Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in an Australian population and (ii) the relationship between these organisms, pocket depths and supragingival plaque scores. Methods: Subgingival plaque was collected from the shallowest and deepest probing site in each sextant of the dentition. In total, 6030 subgingival plaque samples were collected from 504 subjects. An ELISA utilising pathogen-specific monoclonal antibodies was used to quantitate bacterial numbers. Results:: A. actinomycetemcomitans was the most frequently detected organism (22.8% of subjects) followed by P. gingivalis and P. intermedia (14.7% and 9.5% of subjects respectively). The majority of infected subjects (83%) were colonised by a single species of organism. A. actinomyceteincomitans presence was overrepresented in the youngest age group but under-represented in the older age groups. Conversely, P. gingivalis and P. intermedia presence was under-represented in the youngest age group but over-represented in the older age groups. Differing trends in the distribution of these bacteria were observed between subjects depending upon the site of the infection or whether a single or mixed infection was present; however, these differences did not reach significance. Bacterial presence was strongly associated with pocket depth for both A. actinomyceteincomitans and P. gingivalis. For A. actinomycetemcomitans, the odds of a site containing this bacterium decrease with deeper pockets. In contrast, for P. gingivalis the odds of a site being positive are almost six times greater for pockets >3 ram than for pockets less than or equal to3 nun. These odds increase further to 15.3 for pockets deeper than 5 mm. The odds of a site being P. intermedia positive were marginally greater (1.16) for pockets deeper than 3 mm. Conclusions: This cross-sectional study in a volunteer Australian population, demonstrated recognised periodontal pathogens occur as part of the flora of the subgingival plaque. Prospective longitudinal studies are needed to examine the positive relationship between pocket depth and pathogen presence with periodontal disease initiation and/or progression.

Interlaminar differences in the pyramidal cell phenotype in cortical areas 7m and STP (the superior temporal polysensory area) of the macaque monkey

Pyramidal neurones were injected with Lucifer Yellow in slices cut tangential to the surface of area 7m and the superior temporal polysensory area (STP) of the macaque monkey. Comparison of the basal dendritic arbors of supra- and infragranular pyramidal neurones (n=139) that were injected in the same putative modules in the different cortical areas revealed variation in their structure. Moreover, there were relative differences in dendritic morphology of supra- and infragranular pyramidal neurones in the two cortical areas. Shell analyses revealed that layer III pyramidal neurones in area STP had considerably higher peak complexity (maximum number of dendritic intersections per Shell circle) than those in layer V, whereas peak complexities were similar for supra- and infragranular pyramidal neurones in area 7m. In both cortical areas, the basal dendritic trees of layer m pyramidal neurones were characterized by a higher spine density than those in layer V. Calculations of the total number of dendritic spines in the average basal dendritic arbor revealed that layer V pyramidal neurones in area 7m had twice as many spines as cells in layer III. (4535 and 2294, respectively). A similar calculation for neurones in area STP revealed that layer III pyramidal neurones had approximately the same number of spines as cells in layer V (3585 and 3850 spines, respectively). Relative differences in the branching patterns of, and the number of spines in, the basal dendritic arbors of supra- and infragranular pyramidal neurones in the different cortical areas may allow for integration of different numbers of inputs, and different degrees of dendritic processing. These results support the thesis that intra-areal circuitry differs in different cortical areas.

Gill pathology caused by infestations of adult and preadult Dissonus manteri Kabata (Copepoda : Dissonidae) on coral trout, Plectropomus leopardus (Lacepede), (Serranidae)

Adult and preadult Dissonus manteri attached to the gills of Plectropomus leopardus cause significant pathology in the form of large hyperplastic nodules on the afferent (leading), edges of gill filaments. Nodules result from the dual actions of parasite attachment and feeding. The host response is characterized by severe epithelial hyperplasia, supplemented by fibroplasia and inflammation. Parasites attach close to the gill arch near the base of filaments. They have little effect on gill vasculature as the maxillipeds penetrate the filament superficial to the efferent filament artery and do not interfere with the blood vessels of the secondary lamellae. Tissue proliferation is limited to the wide portion of filament 'edge' epithelium in the proximal third and also does not extend to the secondary lamellae. Nodules are most numerous towards the ends of hemibranchs and are generally absent from the central regions. Leading hemibranchs bear significantly more nodules than their trailing counterparts. Of the total number of nodules, 20.5% are located on the pseudobranchs. Distribution patterns are considered to be primarily the result of D. manteri avoiding strong water currents, although this cannot explain the difference between numbers on leading and trailing hemibranchs.

Multi-threading and message communication in Qu-Prolog

This paper presents the multi-threading and internet message communication capabilities of Qu-Prolog. Message addresses are symbolic and the communications package provides high-level support that completely hides details of IP addresses and port numbers as well as the underlying TCP/IP transport layer. The combination of the multi-threads and the high level inter-thread message communications provide simple, powerful support for implementing internet distributed intelligent applications.

Further studies on an intermediate host murine model showing that a primary Echinococcus granulosus infection is protective against subsequent oncospheral challenge

We describe the use of a murine model to evaluate resistance against subsequent challenge following a primary infection with oncospheres of Echinococcus granulosus. Mice (Kunming strain) were infected with hatched oncospheres of Echinococcus granulosus; 21 days later a second challenge was given by a different route of infection. A primary infection by intraperitoneal (i.p.) injection stimulated 100 and 90.5% protection in terms of reduced cyst numbers against a secondary infection given subcutaneously (s.c.) or intravenously (i.v.) respectively. A primary infection given s.c. followed by i.p. or i.v. challenge resulted in 84.0 and 100% protection, respectively. Intravenous infection followed by i.p. or s.c. challenge resulted in 98.5 and 69.4% protection, respectively. With the i.v. route of infection, almost all resultant cysts were present in the lungs. The data show that a primary infection with oncospheres can induce total or a high degree of protection against a subsequent challenge and confirms that natural (concomitant) immunity can be stimulated in the intermediate host as the result of a primary infection. This may explain the decline in hydatid infection in sheep older than 2 years in hyper-endemic areas such as those found in Xingjiang, China. These older sheep may have been earlier infected and have subsequently self-cured, with the primary infection stimulating an immune response that protects the intermediate host animals from further infection. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

Immune-derived opioids and peripheral antinociception

1. Recent findings have suggested a significant involvement of the immune system in the control of pain. Immune cells contain opioid peptides that are released within inflamed tissue and act at opioid receptors on peripheral sensory nerve endings. It is also apparent that different types of lymphocytes contain P-endorphin, memory T cells containing more beta -endorphin than naive cells. 2. These findings highlight an integral link between immune cell migration and inflammatory pain, The present review highlights immune system involvement in the site-directed control of inflammatory pain. 3. Full-length mRNA transcripts for opioid precursor proteins are expressed in immune cells. Increased expression of pro-opiomelanocortin mRNA and beta -endorphin has been demonstrated in stimulated lymphocytes and lymphocytes from animals with inflammation. 4. Cytokines and corticotropin-releasing factor (CRF) release opioids from immune cells, Potent peripheral analgesia due to direct injection of CRF can be blocked by antagonists to CRF, antibodies to opioid peptides, antisense to CRF and opioid receptor-specific antagonists. The release of opioid peptides from lymphocytes is calcium dependent and opioid receptor specific. Furthermore, endogenous sources of opioid peptides produce potent analgesia when implanted into the spinal cord. 5. Activated immune cells migrate directly to inflamed tissue using cell adhesion molecules to adhere to the epithelial surface of the vasculature in inflamed tissue. Lymphocytes that have been activated can express opioid peptides, Memory type T cells that contain opioid peptides are present within inflamed tissue; naive cells are not present in inflamed tissue and do not contain opioid peptides, Inhibiting the migration of memory type T cells into inflamed tissue by blocking selectins results in reduced numbers of beta -endorphin containing cells, a reduced quantity of beta -endorphin in inflamed paws and reduced stress- and CRF-induced peripheral analgesia. 6. Immunosuppression is associated with increased pain in patients. Moreover, immunosuppression results in decreased lymphocyte numbers as well as decreased analgesia in animal models.

Application of heterogeneous vacancy solution theory to characterization of microporous solids

The vacancy solution theory of adsorption is re-formulated here through the mass-action law, and placed in a convenient framework permitting the development of thermodynamic ally consistent isotherms. It is shown that both the multisite Langmuir model and the classical vacancy solution theory expression are special cases of the more general approach when the Flory-Huggins activity coefficient model is used, with the former being the thermodynamically consistent result. The improved vacancy solution theory approach is further extended here to heterogeneous adsorbents by considering the pore-width dependent potential along with a pore size distribution. However, application of the model to numerous hydrocarbons as well as other adsorptives on microporous activated carbons shows that the multisite model has difficulty in the presence of a pore size distribution, because pores of different sizes can have different numbers of adsorbed layers and therefore different site occupancies. On the other hand, use of the classical vacancy solution theory expression for the local isotherm leads to good simultaneous fit of the data, while yielding a site diameter of about 0.257 nm, consistent with that expected for the potential well in aromatic rings on carbon pore surfaces. It is argued that the classical approach is successful because the Flory-Huggins term effectively represents adsorbate interactions in disguise. When used together with the ideal adsorbed solution theory the heterogeneous vacancy solution theory successfully predicts binary adsorption equilibria, and is found to perform better than the multisite Langmuir as well as the heterogeneous Langmuir model. (C) 2001 Elsevier Science Ltd. All rights reserved.