Farm health and safety in rural New South Wales. Insights through qualitative research.

Objectives: To determine the appropriate content and format of a farm health and safety training program for rural health professionals, and to explore issues in rural health care relevant to the health and safety education of the farming community.

Design: Qualitative research by focus group and individual interviews with health care professionals and members of the farming community.

Setting: Four rural New South Wales towns, with a range of agricultural activities.

Neuropsychological and neurological outcome after relapse of lymphoblastic leukaemia.

Fourteen children who relapsed after initial remission of leukaemia were studied. Six received a second course of cranial radiotherapy, while the remaining eight children were given total body irradiation before bone marrow transplantation. The postirradiation somnolence syndrome was common after cranial radiotherapy.

The ulnar artery free flap: the first 7 years.

This paper reviews 7 years of experience with the ulnar artery free flap at the Wellington Regional Plastic Surgery Unit. It has become the free flap we use most commonly to repair defects after resection of intraoral cancers, other head and neck defects, and soft-tissue defects of the lower limbs. Of 56 attempted cases, 52 have been successful.

Dual requirement in yeast DNA mismatch repair for MLH1 and PMS1, two homologs of the bacterial mutL gene.

We have identified a new Saccharomyces cerevisiae gene, MLH1 (mutL homolog), that encodes a predicted protein product with sequence similarity to DNA mismatch repair proteins of bacteria (MutL and HexB) and S. cerevisiae yeast (PMS1). Disruption of the MLH1 gene results in elevated spontaneous mutation rates during vegetative growth as measured by forward mutation to canavanine resistance and reversion of the hom3-10 allele.

Protein A immunoadsorption treatment in hematology: an overview.

Staphylococcal protein A efficiently binds immunoglobulins and circulating immune complexes (CIC) and provides an effective medium to remove immunoglobulins and CICs from plasma while sparing albumin and most coagulation proteins. Although it activates the complement system its clinical use abrogates the need for plasma expanders necessitated by plasma exchange. Despite anecdotal reports of utility in several hematologic syndromes, publications of clinical trials are available only for autoimmune thrombocytopenic purpura (AITP) and refractoriness to platelet transfusions (RFT) associated with alloimmunization.

Detection of antiplatelet antibody with a platelet immunofluorescence assay.

An indirect platelet immunofluorescence assay (PIFA) was developed for detection of circulating antiplatelet antibody in dogs with suspected immune-mediated thrombocytopenia (ITP). The PIFA was performed on 10 healthy dogs with normal platelet counts; 76 thrombocytopenic dogs, 20 of which were suspected of having ITP; and 18 dogs with other diseases and normal platelet counts. All normal dogs and negative test results.

Mantle plume helium in submarine basalts from the galapagos platform.

Helium-3/helium-4 ratios in submarine basalt glasses from the Galapagos Archipelago range up to 23 times the atmospheric ratio in the west and southwest. These results indicate the presence of a relatively undegassed mantle plume at the Galápagos hot spot and place Galápagos alongside Hawaii, Iceland, and Samoa as the only localities known to have such high helium-3/helium-4 ratios. Lower ratios across the rest of the Galápagos Archipelago reflect systematic variations in the degree of dilution of the plume by entrainment of depleted material from the asthenosphere.

A cluster of brain tumours in a New South Wales colliery: a problem in interpretation.

Following the reporting of a cluster of cases of brain tumour in the workforce of an underground coal mine (Mine A) in the Newcastle coalfield, a study was carried out to determine whether this phenomenon was due to chance alone or whether an environmental cause could be postulated. The study design was a historical cohort study over 15 years comparing the incidence of brain tumour (ICD9 191 and 192) in the index mine with that in two control mines (Mines B and C) in the same area and with that in the general Australian population. We compared environmental exposures (ionising and nonionizing radiation and chemical exposure) in the three mines.

Severe thrombocytopenia in an acquired immunodeficiency syndrome patient associated with pentamidine-dependent antibodies specific for glycoprotein IIb/IIIa.

Severe thrombocytopenia developed in a patient with acquired immunodeficiency syndrome during treatment with intravenous pentamidine for Pneumocystis carinii pneumonia. The patient's bone marrow contained adequate numbers of megakaryocytes, suggesting peripheral platelet destruction. Platelet counts ranged between less than 3 and 20 x 10(9)/L for 2 weeks despite cessation of pentamidine, platelet transfusions, high-dose intravenous IgG, and 2 mg/kg/d prednisone.

Detection of clonal platelet antibodies in immunologically-mediated thrombocytopenias: association with circulating clonal/oligoclonal B cells.

Aware that T and B cells in autoimmune thrombocytopenia are abnormal, including the existence of clonal B cell populations, we sought to characterize this clonal phenomenon in various immunological thrombocytopenias using platelet antibody light chain analysis, flow cytometry, Southern blot analysis, and PCR. Using a monoclonal antibody-antigen capture ELISA, we analysed sera from 21 of 26 patients with autoimmune, alloimmune, or drug-induced immunological thrombocytopenia for the light chain phenotypes of their platelet antibodies. Alloantibodies and drug-dependent antibodies from four and 14 patients, respectively, were found that expressed a predominant type of light chain, suggesting that these platelet-reactive antibodies were monoclonal or oligoclonal in nature.

Specificity of drug-induced immune cytopenias.

What conclusions can be drawn concerning specificity of drug-induced immune reactions? We have seen that specificity of these reactions depends on several molecular features including the chemical nature of the drug, specific domains of particular membrane components, and as yet unidentified characteristics that determine selectivity for one or more cell types. This latter property does not seem to be related to shared membrane components because, for example, Rh antigens on RBCs, the peptide tail region of GPIb alpha on platelets, and the 85-kd GP on neutrophils are clearly not part of the same molecules. From multiple studies of quinine/quinidine-dependent and nomifensine-dependent antibody interactions with platelets and RBCs, respectively, we can conclude that these particular reactions are a function of specific features of the drug molecules and specific domains of various membrane glycoproteins.

Chemotherapy: how safe for the caregiver?

Antineoplastic drugs are routinely administered by nurses in the home setting. The potential for nurse occupational exposure to these drugs is increased by an inadequate understanding of the risks inherent in administering these agents. This article addresses issues related to safe administration of these drugs in a home environment.

Endoscopic therapy of pancreatitis in the pediatric population.

Six children with chronic relapsing pancreatitis or acute post-traumatic pancreatic pseudocyst underwent therapeutic pancreatography at the time of ERCP. Procedures included pancreaticobiliary sphincterotomy, pancreatic duct stone removal, and endoprosthesis placement. Four of five patients with chronic pancreatitis had significant symptomatic improvement, whereas the patient with pseudocyst had rapid resolution of symptoms and cyst.

Children with cancer talk about their own death with their families.

In this study we looked at children dying from progressive malignant diseases and their families, to see whether they discussed the child's impending death together. We also looked at what factors might influence this. We questioned staff in the oncology department about their attitude to an open approach in talking about death and their views of how often it occurred.

Characterization of glycoprotein II from bovine adrenal medullary chromaffin granules. Identification of components representing the secretory vesicle counterparts of the lysosomal-associated membrane glycoproteins (lamp-1 and lamp-2).

Glycoprotein II (GpII) is a heterogenous glycoprotein isolated from the membranes of bovine chromaffin granules in the adrenal medulla. When viewed by two-dimensional electrophoresis this glycoprotein consists of two components, upper (GpIIa) and lower (GpIIb), with a molecular mass of 80,000-100,000 daltons and a pI of 4.2-4.

The psychiatric, psychological and behavioural functioning of a boy with terminal deletion of the long arm of chromosome 10.

The developmental and behavioural functioning of a six-year-old boy with deletion of the long arm of chromosome 10 was evaluated using reliable, standardised, psychological inventories. The information obtained clarified his complex pattern of strengths and needs; it also contributes scientifically derived data to the literature on behavioural correlates of this condition.

Cervical cancer: changing trends in the Wellington region.

Aim: To identify changes in patient and tumour characteristics of women with carcinoma of the cervix treated through the Wellington Regional oncology unit between 1975-89.

Methods: The medical records of the patients treated between 1985-9 were reviewed. The age and stage of disease was noted in each case and results compared with the previous two 5-year cohorts.

Treatment of refractoriness to platelet transfusion by protein A column therapy.

Ten thrombocytopenic patients (platelets < 10-24 x 10(9)/L) who were refractory to platelet transfusion were investigated for their responsiveness to staphylococcal protein A column therapy. Nine patients had previously been treated with steroids, intravenous immune globulin, and/or other forms of immunosuppressive therapy without improvement in their transfusion response. All patients were receiving multiple platelet transfusions without achieving 1-hour corrected count increments (CCIs) > or = 7500.

Characterization of platelet activation induced by HLA antibodies associated with alloimmune thrombocytopenia.

The platelet-activating properties of plasma containing multispecific HLA antibodies were studied in plasma from several persons stimulated by platelet or red blood cell transfusion or by pregnancy. Antibodies were characterized by their lymphocytotoxic effects and by a monoclonal antibody antigen--capture enzyme-linked immunoassay. Plasma from each patient induced dose-dependent aggregation and release of adenosine triphosphate with antigen-positive platelet-rich plasma.

Personality characteristics of men who physically abuse women.

Objective: Studies have suggested that personality disorders may be common among men who habitually commit domestic violence. The study reported here attempted to characterize personality traits and psychological and cognitive characteristics of men who batter women in order to distinguish them from nonbattering men.

Methods: A group of 21 batterers were compared with a group of nonbatterers using the Minnesota Multiphasic Personality Inventory and its personality disorder scales (MMPIPDS) and the Hostility and Direction of Hostility Questionnaire.

Dietary protein intolerance in infants with transient methemoglobinemia and diarrhea.

Of 17 infants requiring hospitalization for primary soy or cow milk protein intolerance, six infants (35%) had transient methemoglobinemia. Reexposure to the offending protein caused diarrhea, metabolic acidosis, and transient methemoglobinemia in all patients. These six patients represented 65% of the total hospitalizations resulting from methemoglobinemia of any cause.

Artificial pneumothorax can be used to prevent lung toxicity in chest wall radiotherapy.

We report two patients in whom an artificial pneumothorax was induced to reduce the risk of radiation pneumonitis and fibrosis after treatment for chest wall tumours. The procedure was well tolerated; the only complication observed was a single episode of syncope following over-inflation. High doses of radiation were given to large chest wall fields with no clinical or radiological evidence of pneumonitis or fibrosis, either during or after treatment.

Identification of molecular aggregates containing glycoproteins III, J, K (carboxypeptidase H), and H (Kex2-related proteases) in the soluble and membrane fractions of adrenal medullary chromaffin granules.

An investigation of the molecular properties of glycoprotein III has shown this to be a major component of molecular aggregates present in the membrane and soluble fractions of secretory vesicles from bovine adrenal medulla. These aggregates also contain components identified as glycoproteins H, J, and K which are molecular forms of Kex2-related proteases (glycoprotein H) and carboxypeptidase H (glycoprotein components J and K) and which have functions concerned with the processing of prohormones. A number of experiments indicated that these glycoproteins were associated.