Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy

Polyunsaturated fatty acids (PUFAs) are components of cell membranes and may play an immunomodulating role in the pathogenesis of atopic dermatitis (AD). The goal was to determine the impact of PUFAs on AD by dietary supplementation of infants. Based on the parents' decision on their babies' primary feeding, mothers and newborns were randomized to the supplementation with gamma-linolenic acid (GLA) or placebo for up to 6 months. Breastfed infants received GLA by supplementing their mothers. Formula diet was commercial whey hydrolysate unsupplemented with PUFAs. Of 131 eligible infants, 24 developed AD within the first year of life. Of these, nine belonged to the exclusively breastfed group (n = 58), 14 to the combined-fed group (n = 53), and one to the never breastfed group (n = 20). We could not find an influence of GLA on the development of AD. In subjects with AD, at 1 yr of age the serum-immunoglobulin E (IgE) was the lowest in the GLA-supplemented group A-subjects. In the GLA-supplemented group, GLA-levels in breast milk were similar in atopic and non-atopic infants. In the non-supplemented group the GLA-content of breast milk was 0.07% of total fatty acids in atopic infants vs. 0.17% in non-atopic infants (p < 0.01). Dietary GLA-supplementation could not prevent AD. Interestingly, the number of infants developing AD was the lowest in never breastfed children. In infants suffering from AD, GLA-supplementation seemed to reduce total IgE in the first year of life.     

Minimized surgery for retinal detachments with segmental buckling and nondrainage. An 11-year follow-up.

A prospective study was conducted of 107 retinal detachments operated on between August 1979 and January 1980, with a complete follow-up period ranging from 11 years to 11.5 years. Proliferative vitreoretinopathy (PVR) stage C1 or C2 was seen in 16 detachments. Surgery consisted of cryopexy and segmental buckling (limited to the area of breaks) with nondrainage. Of the surgical procedures, 71% were radial buckles, 19% circumferential, and 10% radial combined with circumferential buckles. The primary reattachment rate was 92.6%, and 97% after reoperation. During the long-term follow-up period, redetachment occurred in 12.1% of the eyes: 5.6% were classified as early redetachments (between 2 and 4 months), and 6.5% as late redetachments (between 3 and 7 years). Early redetachment was caused by PVR, and late redetachment by new holes. After reoperation, reattachment occurred in 92.6% of the eyes. The predominant cause of final failure was PVR (3.7%). Only one eye had two reoperations. There was a highly significant (P less than 0.001) improvement between preoperative visual function (mean 0.32) and postoperative visual function (mean 0.56) in all 99 reattached eyes during the follow-up period (Mann-Whitney U test).     

Human monocyte antigens in a random sample from Japan.

We studied a random sample of Japanese and compared both Japanese and German monocyte antigen frequencies and performed a segregation analysis in Japanese families. In Japanese, the following gene frequencies were established: 0.1033 for HMA-A1; 0.0299 for HMA-A3; 0.0033 for HMA-A6; 0.1521 for HMA-B2. Data on the gene frequency in Germans were presented by Rose. In this comparison, the frequency for HMA-B2 in Japanese is more than two times higher; for antigen HMA-A6, the Japanese is a fifth of the German quantity. The antigen HMA-B4 was not found in Japanese. The results we obtained from family analysis confirmed an unambiguous autosomal, codominant inheritance of the examined HMA antigens.     

Synthesis and transport of GAP-43 in entorhinal cortex neurons and perforant pathway during lesion-induced sprouting and reactive synaptogenesis.

Metabolic labeling and quantitative 2D gel autoradiography were used to assess changes in the synthesis and transport of GAP-43 in entorhinal cortex (EC) neurons and perforant pathway during lesion-induced sprouting and reactive synaptogenesis. In normal adult rats, there is a high constitutive level of GAP-43 synthesis and transport in EC neurons projecting to the hippocampus. Following unilateral EC lesions, there is a 2-fold (100%) increase in the transport of newly synthesized GAP-43 to the contralateral or 'sprouting' hippocampus. The timing of this upregulation (between 6 and 15 days) suggests that changes in GAP-43 expression occur in response to the growth of presynaptic terminals during sprouting.     

Montelukast as add-on therapy to beta-agonists and late airway response.

The present study investigated whether single-dose oral leukotriene receptor antagonists as add-on therapy to short-acting beta-agonists, immediately after allergen challenge, block the late-phase airway response. In total, 35 mild asthmatics (mean age 24 yrs, 19 males) sensitised for house dust mites underwent two courses of bronchial allergen challenge. After the early allergic response (EAR), subjects received salbutamol once and were randomly assigned to either 10 mg of montelukast or placebo (double-blind crossover). To identify a late allergic response, forced expiratory volume in one second (FEV(1)) was monitored over the following 8 h. Baseline exhaled nitric oxide (NO) was determined ahead of each allergen challenge. Baseline NO levels differed significantly depending on the reaction to allergen challenge. In total, 12 subjects showed no significant response, 11 only showed an EAR, and 12 had a dual response and underwent further analysis. The area under the FEV(1) time-response curve 3-8 h after bronchial allergen challenge was -0.77+/-1.68 from the pre-challenge values on montelukast compared with -2.47+/-1.32 on placebo. The baseline exhaled NO fraction of subjects without an EAR was significantly lower than of those presenting a dual response. The results of the present study demonstrate that single-dose leukotriene receptor antagonists given orally right after the early allergic response can significantly inhibit the late allergic response after bronchial allergen challenge.     

Characteristics of teenage mothers and predictors of breastfeeding initiation in the Michigan WIC Program in 1995. Women, Infants, and Children.

Although breast milk is recommended as the optimal source of infant nutrition, breastfeeding initiation is below recommended levels, especially among teenage mothers. Breastfeeding initiation rates among Michigan (US) teenage mothers (12-19 y) were compared by demographics and health behaviors. Multivariate analyses determined which factors were significant independent predictors of breastfeeding initiation among teenage mothers enrolled prenatally in the Michigan Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in 1995. Significant predictors independently associated with breastfeeding initiation were race/ethnicity, education, marital status, postpartum anemia status, parity, prenatal trimester of WIC enrollment, and smoking. The strongest predictor of breastfeeding initiation differed for white mothers (positive predictor: education beyond high school [OR = 3.13]) and black mothers (negative predictor: multiparous [OR = 0.25]). Initiation rates for this population of teenage mothers fall below the national average for mothers of all ages and the US Healthy People 2010 goals. Research is needed concerning how breastfeeding support and education can be improved to reach the US national health goals.     

The volume-deficient orbit: clinical characteristics, surgical management, and results after extraperiorbital implantation of Silastic block.

The surgical techniques and results after extraperiorbital implantation of Silastic on the orbital floor of 70 patients are reviewed. In 11 patients the implant was through a subciliary approach and in 59 through an inferolateral cantholysis. The inferolateral cantholysis, a simplification of the McCord and Moses approach to the orbital floor, is particularly suited to this application. The implanted Silastic was retained in 66 patients, with an average follow up of 3.5 years (range less than 1 to 9.5 years), though six required surgery to debulk the anterior end of the implant. Further surgery was required in 27 patients, this generally being to correct the position of either the upper or the lower lid. Volume enhancement was effective in most cases, there being a significant reduction in the degree of recession of the prosthesis and the depth of the unsightly sunken sulci of the upper and lower lids. The mobility of the orbital contents, the prosthesis, and the upper lid was not improved.