Identification and cloning of a complementary DNA encoding a vicilin-like proprotein, Jug r 2, from English walnut kernel (Juglans regia), a major food allergen

Background: Walnuts and other tree nuts are important food-allergen sources that have the potential to be associated with life-threatening, IgE-mediated systemic reactions in some individuals. Objective: The purpose of this study was to characterize a complementary (c)DNA clone encoding one of the walnut food allergens. Methods: A cDNA expression library prepared from walnut somatic embryo was screened for IgE reactivity with patient serum. A reactive clone of 2060 bp, which encoded a protein of 593 amino acids in length, was subcloned by excision into the pGEX expression vector. IgE-binding inhibition experiments were performed.Results: A recombinant fusion protein was induced and shown to bind serum IgE from 9 of 15 patients tested, thus identifying a major allergen. This clone, named Jug r 2, exhibited significant homology with genes encoding the vicilin group of seed proteins. An IgE-binding inhibition experiment suggested that the encoded protein undergoes posttranslational modification into at least one major polypeptide (47 kd) and possibly several others, which is similar to the vicilin-like proteins characterized in cocoa bean (Theobroma cacao) and cottonseed (Gossypium hirsutum ). N-terminal sequencing of the 47-kd band, Jug r 2, identified it as a mature protein obtained from the precursor. A second IgE-binding inhibition experiment showed that there is minimal or no cross-reactivity between Jug r 2 and pea vicilin, peanut proteins, or cacao proteins. Conclusion: Jug r 2 is the third vicilin food allergen identified in addition to vicilins from soy and peanut. The availability of recombinant food allergens should help advance studies on the immunopathogenesis and possible treatment of IgE-mediated food hypersensitivity. (J Allergy Clin Immunol 1999;1311-20.)     

Allergy to the heat-labile proteins α-lactalbumin and β-lactoglobulin in mare’s milk

BACKGROUND: Allergy to mare’s milk is rare. Recently, however, mare’s milk has been recommended for treatment of various ailments by practitioners of “alternative medicine,” and it is available in health food stores. OBJECTIVE: We report a case of allergic reaction to mare’s milk in a 51-year-old woman who was able to tolerate cow’s milk. METHODS: The protein composition of mare’s milk was determined by methods based on measurement of nitrogen content. The patient underwent prick and intracutaneous tests with commercially available bovine milk proteins and several mare’s milk preparations, including mare’s milk granulate and boiled mare’s milk. RAST and immunoblotting were also performed. RESULTS: Results of skin testing and RAST with cow’s milk were negative but demonstrated an IgE-mediated allergy to mare’s milk. Immunoblotting revealed two allergen bands with molecular weights of 16 and 18 kd, most likely representing the whey proteins α-lactalbumin and β-lactoglobulin. The bands disappeared after the mare’s milk was boiled, indicating that the proteins are heat-labile. CONCLUSION: The results of this study demonstrate the existence of an IgE-mediated mare’s milk allergy caused by low molecular weight heat-labile proteins, most likely α-lactalbumin and β-lactoglobulin, which do not cross-react with the corresponding whey proteins in cow’s milk. (J ALLERGY CLIN IMMUNOL 1996;97:1304-7.)     

Experiences and management of breast cancer‐related lymphoedema: a comparison between South Africa and the United States of America

WANCHAI A., STEWART B.R. & ARMER J.M. (2011) Experiences and management of breast cancer‐related lymphoedema: a comparison between South Africa and the United States of America. International Nursing Review 59 , 117–124 Purpose: Approximately one third of breast cancer survivors are estimated to develop lymphoedema. This study was conducted in the midwestern region of the USA and in Western Cape, South Africa. The purpose of this study was to compare and contrast lymphoedema experiences and lymphoedema managements between breast cancer survivors from the two countries . Methods: Using a qualitative research design, data were collected from 29 women with a history of breast cancer‐related lymphoedema (18 women from the USA and 11 women from South Africa ) who consented to semi‐structured interviews. Findings: Six themes regarding effects of lymphoedema emerged from the study including difficulties with daily activities, unmet lymphoedema preparations, facing public curiosity, time‐consuming wrapping, trouble with fitted clothes and a reminder of breast cancer. Four themes regarding lymphoedema management included compression garments, physical activities and faith, as well as other strategies such as compression pumps or antibiotics for infection. Conclusion: Experiences about lymphoedema and its management for breast cancer survivors from both countries were somewhat similar and somewhat different. Collaboration between healthcare providers from both countries should be planned to develop culturally appropriate lymphoedema symptom management interventions for each country.     

An ultrastructural study of the effects of bisphosphonate administration on osteoclastic bone resorption during relapse of experimentally moved rat molars

This study was designed to clarify the effects of systemic administration of bisphosphonate, pamidronate, on the bone resorbing activity of osteoclasts during relapse of rat molars, after experimental movement. An elastic band was inserted between the upper first and second molars of 7-week-old rats and removed 21 days later. At 1 day before elastic band removal, bisphosphonate was administered via a tail vein. After elastic band removal, the rats were further maintained for 0, 5, or 10 days. The relapse of the first molars was studied by means of light and scanning-electron and transmission-electron microscopy. When an elastic band was removed, the mean interdental distance between the first and second molars in all rats was approximately 435 micrometer. In the control rats, it had decreased to 108 micrometer by day 5 and 57 micrometer by day 10. In these control rats, numerous osteoclasts appeared along the alveolar bone surface in the compressed side of the periodontal ligament of first molars. Administration of bisphosphonate significantly inhibited the prominent decrease in interdental distance. In these rats, it averaged 313 micrometer at day 5 and 115 micrometer at day 10. In bisphosphonate-treated rats, osteoclasts aggregated mainly in vascular canals of alveolar bone but were occasionally observed along the alveolar bone surfaces facing the periodontal ligament. Administration of bisphosphonate also induced structural changes, such as disappearance of ruffled borders and cytoplasmic polarity, in osteoclasts. A degenerated osteoclast was also observed in a bisphosphonate-treated rat. However, bisphosphonate induced no structural changes in osteoblasts, osteocytes, or periodontal ligament fibroblasts. These results suggest that a single systemic administration of bisphosphonate decreases the extent of initial relapse in experimentally moved rat molars via a mechanism involving impairment of the structure and resorptive functions of osteoclasts.     

Tissue remodeling as a feature of persistent asthma

A chronic inflammatory process is almost invariably associated with tissue damage and healing. Healing results in repair and replacement of dead or damaged cells by viable cells. Repair usually involves 2 distinct processes: regeneration, which is the replacement of injured tissue by parenchymal cells of the same type, and replacement by connective tissue and its eventual maturation into scar tissue. In many instances both processes contribute to the healing response. Chronic inflammatory disease can therefore lead to a wide variety of consequences, from complete or partial restitution of organ structure and function to fibrosis. Asthma is characterized by a chronic inflammatory process of the airways. The ensuing healing process results in structural alterations referred to as a remodeling of the airways. The mechanisms underlying these structural alterations are still largely unknown. They are likely to be heterogeneous, leading—through the highly dynamic process of cell de-differentiation, migration, differentiation, and maturation—to changes in connective tissue deposition and to the altered restitution of airways structure, resulting in mucus gland hyperplasia, neovascularization, fibrosis, and an increase in smooth muscle mass. (J Allergy Clin Immunol 2000;105:1041-53.)     

An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement

Patients undergoing orthodontic treatment can experience significant levels of pain. This study assessed the effectiveness of preoperative ibuprofen in reducing the incidence and the severity of pain after orthodontic separator placement. Sixty-three adolescent patients (mean age, 13 years) were included in this randomized, double-blind, placebo-controlled, prospective study. Patients were randomly assigned to 1 of 3 experimental conditions: (1) 400 mg of ibuprofen taken orally 1 hour before separator placement and a lactose placebo taken orally immediately after the appointment, (2) a lactose placebo taken orally 1 hour before separator placement and 400 mg of ibuprofen taken orally immediately after the appointment, or (3) a lactose placebo taken orally 1 hour before separator placement and again immediately after the appointment. The patient's level of discomfort was assessed with a visual analog scale at 2, 6, and 24 hours, as well as at 2, 3, and 7 days after placement of the orthodontic separators. An analysis of variance and Duncan's multiple range test revealed that 2 hours after their orthodontic appointment the patients who had taken ibuprofen 1 hour before separator placement had significantly less pain with chewing than did the patients who received either ibuprofen postoperatively or a placebo. Additional measures suggest a trend for less pain for this group of patients. These results support the use of pretreatment ibuprofen for patients requiring analgesics for orthodontic discomfort. Future study of the use of preemptive analgesics in orthodontics is warranted.     

The friction and wear patterns of orthodontic brackets and archwires in the dry state

Frictional resistance at the bracket-archwire interface has been demonstrated to impede tooth movement when sliding mechanics are used. Thus, the coefficients of friction of titanium and stainless steel brackets used in conjunction with stainless and ion-implanted beta-titanium archwires were investigated using a single contact interface between the brackets and archwires. The wear patterns between the brackets and the.016- in flat archwire surfaces were also examined using scanning electron microscopy and energy dispersive x-ray analysis. Stainless steel brackets tested with. 016-in flat stainless steel wire surfaces recorded the lowest coefficient of static friction mean (0.289), whereas titanium brackets paired with.016-in flat ion-implanted beta-titanium wire surfaces produced the highest mean (0.767). Stainless steel brackets had significantly (P <.05) lower coefficients of friction than titanium brackets for all wires except.020-in round stainless steel wires. Ion-implanted beta-titanium wires generally had significantly larger coefficients of friction than stainless steel wires. The increased friction of the titanium and ion-implanted beta-titanium alloys is also reflected in the severity of their wear patterns. An inverse relationship between friction and archwire surface dimension was generally found for ion-implanted beta-titanium wires. Round stainless steel wires demonstrated lower coefficients of kinetic friction than the flat stainless steel wire surfaces.     

Intraoperative EBRT and resection for renal cell carcinoma

Purpose

We report the outcomes of a multimodality treatment approach combining maximal surgical resection and intraoperative electron radiotherapy (IOERT) with or without external beam radiation therapy (EBRT) in patients with locoregionally (LR) recurrent renal cell carcinoma (RCC) after radical nephrectomy or LR advanced primary RCC.

Patients and methods

From 1983 to 2008, 25 patients with LR recurrent (n?=?10) or LR advanced primary (n?=?15) RCC were treated with this approach. Median patient age was 60 years (range, 16–79 years). Fifteen patients (60%) received perioperative EBRT (median dose, 44 Gy). Surgical resection was R0 (negative margins) in 6 patients (24%) and R1 (residual microscopic disease) in 19 patients (76%). The median dose of IOERT was 14 Gy (range, 9–15). Overall survival (OS) and relapse patterns were calculated using the Kaplan–Meier method.

Results

Median follow-up for surviving patients was 22.2 years (range, 3.6–26 years). OS and DFS at 5 and 10 years were 38% and 18% and 19% and 14%, respectively. LR control (tumor bed or regional lymph nodes) and distant metastases-free survival rates at 5 years were 80% and 22%, respectively. The death rate within 30 days of surgery and IOERT was 4% (n?=?1). Six patients (24%) experienced acute or late toxicities of grade 3 or higher according to the National Cancer Institute Common Toxicity Criteria (NCI-CTCAE) v4.

Conclusion

In patients with LR recurrent or LR advanced primary RCC, a multimodality approach consisting of maximal surgical resection and IOERT with or without adjuvant EBRT yielded encouraging local control results, justifying further evaluation.