Proteins with molecular masses of 25 to 40 kilodaltons elicit optimal protective responses against Plasmodium chabaudi adami infection.

The presence of the CD4+ T cell has been shown to be crucial for resolution of acute infection in the Plasmodium chabaudi adami murine malaria model. This model is, therefore, suitable for the isolation of malaria antigens that are capable of activating protective T cells. In light of this, we set out to identify P. chabaudi adami molecules that activate protective responses in this model. Denatured P. chabaudi adami proteins were isolated by continuous-flow electrophoresis on the basis of their apparent molecular masses and then sequentially assessed for the ability to protect mice in immunization experiments. We report here that low-molecular-mass P. chabaudi adami polypeptides in the range from 25 to 40 kDa are most effective at immunizing mice against a challenge infection with viable P. chabaudi adami. The method used to obtain these proteins could also be applied to identify molecules that activate protective cell-mediated responses in other infectious disease models.     

Soluble Fas and soluble Fas ligand proteins in human milk: possible significance in the development of immunological tolerance

Human milk contains a complex uncharacterized, immune system able to exert actions both locally and systemically. This study reports the results of an ELISA-based quantitation of soluble Fas and soluble Fas ligand in human milk which may modulate the Fas/FasL system that is critical for the expression of immune tolerance and apoptosis. Production of Fas/FasL mRNAs by milk cells was also examined using RT-PCR. Fas is ubiquitously expressed in various cells and when bound by its ligand FasL, present predominantly on activated T- and NK cells, Fas-expressing cells are killed. A large amount of soluble Fas (1746-4320 pg/ml) is detected in colostrum, transitional milk and the mature milk of mothers delivering prematurely or at full-term, whereas FasL is present only in the range 123-310 pg/ml. Milk cells are positive for Fas mRNA, but negative for FasL mRNA. An excess of soluble Fas in human milk may bind to FasL preventing apoptosis and preserving epithelial barriers, and may represent an additional new mechanism whereby human milk favours immune tolerance and normal gastrointestinal development.     

Radiotherapy for stage I and II testicular seminomas: Secondary malignancies and survival

Introduction

Testicular seminoma affects relatively young men with excellent survival outcomes. There has been increasing concern that radiotherapy (RT) leads to secondary malignant neoplasms (SMNs) and subsequent mortality. We evaluated the effect of RT on incidence of SMNs and quantified cancer-related mortality and other causes of death for patients with stage I and II testicular seminoma.

Oral Health,Dental Insurance and Dental Service use in Australia

This study uses data from the 2004–2006 Australian National Survey of Adult Oral Health and a simultaneous equation framework to investigate the interrelationships between dental health, private dental insurance and the use of dental services. The results show that insurance participation is influenced by social and demographic factors, health and health behaviours. In turn, these factors affect the use of dental services, both directly and through insurance participation. Our findings confirm that affordability is a major barrier to visiting the dentist for oral health maintenance and treatment. Our results suggest that having supplementary insurance is associated with some 56 percentage points higher probability of seeing the dentist in the general population. For those who did not have private insurance cover, we predict that conditional on them facing the same insurance conditions, on average, having insurance would increase their visits to the dentist by 43 percentage points. The uninsured in the survey have lower income, worse oral health and lower rates of preventive and treatment visits. Copyright © 2015 John Wiley & Sons, Ltd.     

Step-Down Approach for Pharyngoesophageal Corrosive Stricture: Outcome and Analysis

Background

Pharyngoesophageal stricture (PES) is an Achilles’ heel in the management of corrosive injury. Advances in endoscopic techniques were utilized in its management. We classified the stricture as per its dilatability and then planned their treatment.

Methods

PES was sub-categorized based on endoscopic dilatation and availability of cervical oesophagus: group-1 stricture with available cervical oesophagus; group-2 stricture with some part of upper oesophagus made available after endoscopic dilatation and anastomosis in cervico-pharyngeal area; group-3 stricture not amenable for dilatation, anastomosis done at the pharynx. Endoscopic dilatation was performed using through-the-scope pyloric balloon. Number and duration of dilatation sessions before surgery, incidence of tracheostomy, time and incidence for re-stricture and present status of swallowing were evaluated.

Results

Of 226 patients managed, 46 underwent oesophageal replacement for PES. Group 1, 2 and 3 had 12, 14 and 20 patients, respectively. An average 3 (2–4) preoperative balloon dilatation sessions were performed over 6–8 weeks. Tracheostomy was required in 1, 0, 8 patients (p = 0.010), and median hospital stay was 10, 9 and 13 days (p = 0.09) in group 1, 2, 3, respectively. Re-stricture developed in 4/12, 4/14, 9/20 patients with average sessions of dilatation required in post-operative period was 4, 3.5 and 8 in group 1, 2, 3, respectively. >90% of patients are taking normal diet in each group.

Conclusion

We attempted to avoid the high anastomosis by dilating the PES and step down the level of anastomosis in two-third patients. We thereby avoided tracheostomy, aspiration and swallowing problems related to high strictures.