The control of viral diseases in the developing countries with the use of existing vaccines]

In developing countries, every year about 70 million measles cases occur with 1.5 million deaths, over 200,000 children contract paralytic poliomyelitis, 50 million people get infected with viral B hepatitis causing over 1 million deaths, and several thousand people perish because of yellow fever according to WHO data. At the present time, there are 12 vaccines against viruses: vaccines against German measles and mumps in addition to the above. The universal immunization program (UIP) of WHO targets measles and polio. In 1989, a WHO resolution envisioned a 90% immunization coverage by the year 2000. Measles vaccination is recommended for children aged 9-23 months, since most children have maternal antibodies during the first 3-13 months of age. The Edmonston-Zagreb vaccine provided seroconversion of 92, 96, and 98% for 18 months vs. the 66, 76, and 91% rate of the Schwarz vaccine. In the US, measles incidence increased from 1497 cases in 1983 to 6382 cases in 1988 to over 14,000 cases in 1989, prompting second vaccination in children of school age. The highest incidence of polio was registered in Southeast Asia, although it declined from 1 case/100,000 population in 1975 to .5/100,000 in 1988. Oral poliomyelitis vaccine (OPV) provides protection: there is only 1 case/2.5 million vaccinations. Hepatitis B has infected over 2 billion people. About 300 million are carriers, with a prevalence of 20% in African, Asian, and Pacific region populations. Plasmatic and bioengineered recombinant vaccine type have been used in 30 million people. The first dose is given postnatally, the second at 1-2 months of age, and the 3rd at 1 year of age. Yellow fever vaccine was 50 years old in 1988, yet during 1986-1988 there were 5395 cases with 3172 deaths in Africa and South America. Vaccination provides 90-95% seroconversion, and periodic follow-up vaccinations under UIP could eradicate these infections and their etiologic agents.     

Control of hydatidosis in the Province of Rio Negro, Argentina: epidemiology]

In this paper we attempt to present a general view of the situation of hydatidosis in the Province of Rio Negro, Argentina, considering the magnitude of infection in man and dog. Because of its seriousness a 10 year program for the control of hydatidosis has been carried out, which included veterinary and medical care. The number of human cases with hydatidosis in the period 1981-1988 was determined by a retrospective study of the registers of Public Health. From 1188 cases registered in the period, the annual numbers varied between 152 in 1981 and 104 in 1988. This implies an incidence rate of 40 x 100,000. The most frequent localization observed was in the liver. The average days of hospitalization has decreased to 15.8 per patient. Screening seroepidemiological surveys using DD5 allowed us to determine that the prevalence rate was in some departments of 2330 x 100,000. Also included are the results, up to now, of 10 years of field work done in the program area.     

Effects of ATP on regulation of galactosyltransferase-I activity responsible for synthesis of the linkage region between the core protein and glycosaminoglycan chains of proteoglycans.

We report that ATP enhances the activity of galactosyltransferase-I, which synthesizes the linkage region between glycosaminoglycan chains and the core proteins of proteoglycans. The enzyme activity in cell-free fractions prepared from cultured human skin fibroblasts was measured by high-performance liquid chromatographic detection of galactosyl-xylosyl-(4-methylumbelliferone) produced from 4-methylumbelliferyl-beta-D-xyloside used as an acceptor. ATP at 2 mM increased the enzyme activity by about 60% in the 110 x g supernatant of the cell homogenate, but not in the supernatant or precipitate fractions obtained by 100,000 x g centrifugation. When both fractions (the 100,000 x g supernatant and precipitate) were mixed, the additional ATP increased the enzyme activity. This increase was canceled by heat treatment or trypsin digestion of the 100,000 x g supernatant. In addition, the 100,000 x g precipitate, which was prepared from the 110 x g supernatant preincubated with ATP, exhibited increased activity, and this increase was abolished by alkaline phosphatase treatment. These results suggest that a protein kinase in the 100,000 x g supernatant activates galactosyltransferase-I activity.     

Epidemiology of Malignant Melanoma in Central Europe: Risk Factors and Prognostic Predictors. Results of the Central Malignant Melanoma Registry of the German Dermatological Society

The Central Malignant Melanoma Registry (CMMR) of the German Dermatological Society was established in 1983, and 7789 cutaneous malignant melanomas (CMM) were registered by 35 dermatological departments in Germany, Austria and Switzerland until the end of 1989. Population-based incidence rates, risk factors for developing CMM and prognostic parameters for predicting the final outcome were investigated in separate multicenter studies performed by the CMMR. Among the 7789 CMM registered, there was a preponderance of females (57.7%) versus males (42.3%). The age distribution peaked in the 5th and 6th decade of life for both sexes with a mean age of 52 years. The mean detection age was 50 years for superficial spreading melanoma, 53 for nodular melanoma, and 65 for lentigo maligna melanoma. Mean tumor thickness decreased from 2 mm in 1983 to 1.5 mm in 1989, indicating better CMM-awareness of the population and the medical community in this area. 90% of the patients presented with clinical stage I CMM without detectable metastases at first diagnosis. The incidence of CMM in Berlin (West) was assessed based on 960 cases diagnosed between 1980 and 1986. The incidence increased by 49% between 1980-81 and 1985-86, and the age standardized-incidence rate (European standard population) was 9.8 for males and 7.8 for females per 100,000 inhabitants and year in 1985-86. Mortality rates decreased in this period from 3.5 to 2.6 for males and slightly increased for females from 1.2 to 1.6 per 100,000 inhabitants and year. A case control study on the relative risk (RR) for developing CMM revealed the total number of melanocytic nevi (MCN) to be the strongest risk predictor (15x - 50x increased RR), followed by the presence of dysplastic MCN (7x increased RR) and the skin type I (2x increased RR). Interestingly, no differences between CMM-cases and controls were found with respect to the history of sunburns or other parameters of sun exposure in this study. Multivariate analysis of 5093 stage I CMM-patients from four departments with long-term follow-up revealed that tumor thickness is the strongest predictor of survival with an almost linear correlation to the risk of death for tumor thickness up to 6 mm with no further increase in mortality for higher tumor thickness. The best classification of tumor thickness for survival prediction was 1 mm, 1.01 ?2 mm, 2.01 ?4 mm and > 4 mm in our data set on 5093 patients. Sex was found to be the second most important prognostic factor showing a significant advantage for females. Furthermore, a high risk was identified for tumors localized on the upper trunk, upper arm, neck and scalp on the upper trunk, upper arm, neck and scalp (=TANS); the anatomical site, therefore, should be taken into account for a prognostic classification of primary CMM.     

Vegetation changes caused by recent fires in the northern boreal forest of eastern Canada

Abstract. From 1980–1989, fires burned 32 440 km² of boreal forest, 200 km south of the forest-tundra border in northern Québec, Canada. An assessment of the impact of fire on tree population densities was carried out by comparing the number of Pinus banksiana and Picea mariana in 83 sites before and after the sites burned in 1981, 1983, 1988 or 1989. Age structure analysis of post-fire populations burned in 1972, 1976 and 1983, along with the rapid exhaustion of the seed bank from burned trees, suggest that the majority of seedlings were established within 3 to 10 yr after fire. Consequently, given the absence of nearby living seed bearers, little (if any) further recruitment can be expected in the even-aged, regenerating populations. According to the tree density comparison (pre-fire vs post-fire), a shift from Picea- to Pinus-dominated communities occurred in most of the sites burned in 1981 or 1983, and in some of the sites burned in 1988 or 1989. The 1988 fire reduced the tree population density by 95% in 10 of the 15 sites; total tree density decreased by at least 75% in 28 out of 40 sites burned in 1989. This suggests that the areas burned in 1988 and 1989 will mainly regenerate as very open forests or lichen-heath communities that are more commonly found in the forest-tundra zone, north of the study area. Fire intensity, short fire interval, and unfavorable climate during and after fires are three plausible mechanisms associated with these post-fire vegetation changes.     

Six years' audit of laboratory workload and rates of referral for colposcopy in a cervical screening programme in three districts.

OBJECTIVE--To determine laboratory workload and rates of referral for colposcopy in a three district cervical screening programme during 1983-9 to assess the feasibility of accommodating call up of all women at risk, recall at three year intervals (now five year intervals), and investigation of women with all degrees of abnormality. DESIGN--Analysis of computerised screening histories dating back to 1977 of women screened in the Avon cervical screening programme. SETTING--Three district health authorities covering the population of Bristol and Weston-super-Mare, comprising 800,000 people, of whom 250,000 were female residents aged 20 to 64. SUBJECTS--196,977 Women aged 20 to 64 screened in cervical screening programme since 1983. RESULTS--Laboratory workload devoted to follow up of women with abnormalities increased sharply between 1987-8 and 1988-9, with increases of 54% (from 2075 to 3196) in the number of smears for follow up of severe dyskaryosis and invasive cancer, 40% (from 1925 to 2695) for mild and moderate dyskaryosis, and 49% (from 1793 to 2677) for borderline change. The increases were partly explained by the introduction in April 1988 of protocols for follow up and investigation based on guidance in an intercollegiate working party report. The proportion of women with mild and moderate dyskaryosis who were recommended for referral for colposcopy increased steadily from 9.9% in 1983-4 to 79.9% in 1988-9, and for borderline change the proportions were 3.5% and 13.6% respectively. Of all women tested in 1988-9, referral for colposcopy was recommended in 3%. CONCLUSIONS--The increase in laboratory follow up work identified, if it continued, could result in half of existing laboratory capacity in Avon being devoted to follow up work by 1993, with little prospect of maintaining call, recall, and quality control. Investigation of all women with minor cytological abnormalities is neither justifiable nor sustainable and will undermine the benefits of screening by increasing the rate of false positive results and the financial costs.     

Seroepidemiological studies of HIV-1 infection in large Brazilian cities

The prevalence of HIV-1 antibodies in selected groups of individuals from Rio de Janeiro, S?o Paulo and Santos was determined retrospectively. These groups and respective prevalences were: hemophiliac patients from Rio de Janeiro (1983-1984) 98.0%; polytransfused hemodialysis patients from S?o Paulo (1985-1986) 3.0% and (1987) 7.7%; intravenous drug addicts from S?o Paulo and Rio de Janeiro (1986-1987) 15.9%; male prisoners from S?o Paulo (1988) 12.5%, and pregnant women from Santos (1988-1989) 3.6%. These data stress the magnitude of AIDS in Brazil.     

Plankton size distributions and trophic relations before and after the construction of the storm-surge barrier in the Oosterschelde estuary

Phytoplankton and zooplankton biomass distributions were calculated on a carbon basis for the inland part of the Oosterschelde, in the period before (1983), during (1984, 1986) and after (1987, 1988) the construction of the storm- surge barrier. In all years studied, both phytoplankton and zooplankton distributions are very irregular, and little consistent patterns emerge. The data were used to test the model of Sheldon et al. (1977). The observed standing stock ratios of zooplankton to phytoplankton agree with the model predictions in 1983, and are slightly higher during the period 1984–1987. In 1988, the model predictions are very different from the observed values, because of important changes in the zooplankton species abundance occurring in this year.     

我国中东部地区土地利用／土地覆盖动态分析

在野外调查和资料收集的基础上,利用遥感和地理信息系统技术,对中国中东部地区19个省(直辖市)1988年和2000年的5种土地利用／覆盖类型的遥感数据进行了景观制图及其叠加分析．结果表明,12年来。随着中东部地区经济和人口数量的快速增长,耕地及城建用地面积分别增加了10．921×10^5hm^2和13．754×10^5hm^2．比1988年增长了2．14％和19．25％．对木材的大量需求及毁林开荒,导致林地面积减少了17．83×10^4hm^2．比1988年下降了1．12％．草地面积增加了19．287×10^5hm^2,比1988年上升7．75％．长期对土地的不合理利用带来的环境条件恶化,使草地覆盖度及草地质量总体呈下降趋势．10年间对未利用地面积的开发达49．61×10^4hm^2,占1988年未利用地面积的34．31％．     

Regulation of cytosolic COX-2 and prostaglandin E2 production by nitric oxide in activated murine macrophages

Murine macrophages (RAW 264.7) when stimulated with LPS show 90% distribution of cyclooxygenase-2 (COX-2) in the nuclear fraction and approximately 10% in the cytosolic fraction. Further analysis of this cytosolic fraction at 100,000 x g indicates that the COX-2 is distributed both in the 100,000 x g soluble fraction and membrane fraction. Stimulation of RAW 264.7 cells with LPS in the presence of inducible nitric oxide synthase inhibitor L-NMMA at concentrations that inhibit nitrite accumulation by /=85% with higher concentrations of L-NMMA shows 1) up-regulation of PGE2 production, 2) accumulation of COX-2 protein in the 100,000 x g soluble and membrane fractions of the cytosolic fraction, and 3) with no significant effects on the accumulation of COX-2 mRNA. These experiments suggest that low concentrations of nitric oxide (10-15% of the total) attenuate PGE2 production in response to LPS in RAW 264.7 cells. This inhibition is, in part, due to decreased expression of cytosolic COX-2 protein.     

Priority issues in continuing medical education show sensitivity to change in Canadian health care.

The degree and scope of significant change in health care expectations, roles and delivery patterns in Canada have been widely documented. In 1988 the Sub-Committee on Research of the Standing Committee on CME [continuing medical education], Association of Canadian Medical Colleges, conducted a survey to determine whether those responsible for the CME portion of the medical school curriculum are changing their perceptions to keep pace with the changes in health care. The results were compared with those of a similar survey done in 1983. In both surveys people directly responsible for delivery of formal CME were asked to identify and rank research needs in CME. The response rates were very high. The CME issues identified in the two surveys had changed considerably, with entirely new issues being identified in 1988 and the emphasis placed on issues having changed. The identification of factors that promote or inhibit application of new knowledge by practising physicians was of lowest importance in 1983 and of primary importance in 1988, and comparison of the cost-effectiveness of CME methods was an important issue in 1983 and among the least important in 1988. The noted changes mirror developments in Canada''s health care milieu.     

Spread of salmonellosis in Moscow and the ways of its prophylaxis

The article deals with the results of the epidemiological analysis of the spread of salmonellosis in Moscow. During the last 15 years the proportion of Salmonella enteritidis was about 80% and more. After salmonellosis morbidity decreased to 19.9 per 100,000 of the population (the minimum level) in 1985 its sharp rise was noted. Morbidity rate increased from 31.7 in 1987 to 55.1 per 100,000 in 1988, then to 93.9 per 100,000 of the population in 1989 (the maximum level). In the subsequent years up to 1996 a decrease in morbidity rate was observed, but in 1997-2002 morbidity rate stabilized within 29.8-35.7 per 100,000 of the population without a perceptible tendency towards decrease. The sharp increase of the etiological role of S. enteritidis which led to a wide spread of Salmonella infections was caused by the "chicken-egg" factor of their transmission. High morbidity rate among children and adults, registered all the year round, is the consequence of the constant epidemic activity of this factor.     

Insulin dependent diabetes in children under 5: incidence and ascertainment validation for 1992.

OBJECTIVE--To establish the incidence of insulin dependent diabetes diagnosed in children under 5 years of age in the British Isles during 1992, comparing the national and regional results with those of our 1988 national study, and estimating the 1992 study''s level of case ascertainment. DESIGN--Active monthly reporting of cases by consultant paediatricians through the framework of the British Paediatric Surveillance Unit, with additional reports from specialist diabetes nurses and regional health authorities. SUBJECTS--All children diagnosed under the age of 5 years with primary insulin dependent diabetes from 1 January to 31 December 1992 (inclusive) and resident in the British Isles at diagnosis. RESULTS--387 children (208 boys and 179 girls) were confirmed to have insulin dependent diabetes, giving a national incidence of 9.3/100,000/year. This is similar to the 9.9/100,000/year found in 1988. Three sample capture-recapture analysis, which could only be applied across the 12 (out of 18) regions supplying regional information to the study, suggested ascertainment rates of 78% for the British Paediatric Surveillance Unit, 67% for specialist nurses, 69% for regional health authorities, and 99% for the aggregated registry. CONCLUSIONS--The national incidence of diabetes in the under 5s in the British Isles did not differ between 1988 and 1992. Nearly complete (99%) ascertainment of cases was possible only for regions for which three data sources were available. Capture-recapture analysis highlighted both the need for more than one data source and for each data source to be complete for the whole study area.     

Prevalence of multiple sclerosis in five rural Suffolk practices.

OBJECTIVE--To determine a point prevalence of multiple sclerosis in part of Suffolk. DESIGN--Multiple source search for patients with multiple sclerosis in five general practices. Patients were reviewed and categorised by using general practice notes. SETTING--Five rural general practices in Suffolk, 12 May 1988. SUBJECTS--31,379 patients registered with five practices. MAIN OUTCOME MEASURES--Multiple sclerosis diagnosed by a specialist. RESULTS--The search produced a provisional list of 62 eligible patients with multiple sclerosis. Review of case notes showed that 48 had probable disease, 10 early disease, and four possible disease. The probable cases gave a crude prevalence of 153/100,000 population (95% confidence interval 109/100,000 to 196/100,000). CONCLUSIONS--Although the results should be interpreted cautiously because of the small sample size, they suggest that the prevalence of multiple sclerosis in Suffolk is higher than has been estimated from hospital data.     

An analysis of the impact of the Schistosomiasis Control Programme in Brazil

The impact of the Schistosomiasis Control Programme (PCE) in Brazil was analyzed, covering the period 1976 to 2003, using the following indicators: percentage of Schistosoma mansoni carriers detected among the population examined in the coproscopic surveys (PPS): mortality rate for schistosomiasis, per 100,000 inhabitants (TME): hospitalization rate for schistosomiasis, per 100,000 inhabitants (TIE): average age of deaths caused by schistosomiasis (IMOE). There was a 38.5% reduction in the PPS after the introduction of the PCE, attributed to the treatment of carriers. Even in hyper-endemic municipalities, such as Conde and Cuitegí, in the state of Paraíba, the PPS fell more than 50% after the first year of treatment. The parasitic burden of the carriers also decreased in the two municipalities. The TME was reduced by 63.4% and the TIE by 77.3%. The mortality rate was highest among the 50-and-above age group. The country's IMOE rose 32.3%. The IMOE was seen to be much lower in the state of Minas Gerais, where the PCE was only initiated in 1983, with very limited coverage.     

rap1B, a cAMP-dependent protein kinase substrate, associates with the platelet cytoskeleton

rap1B is a member of the ras superfamily of low molecular weight GTP binding proteins which constitutes a focal point of GTP and cAMP signal transduction systems. Like other members of this superfamily, rap1B is membrane-associated in resting platelets, presumably through polyisoprenylation. The studies presented here were undertaken to determine the subcellular changes in rap1B localization during cell activation. Activated and unactivated platelets were fractionated by Triton X-100 lysis followed by differential centrifugation to obtain a 10,000 x g cytoskeleton fraction, a 100,000 x g membrane skeleton fraction, and a 100,000 x g supernatant fraction containing solubilized proteins. In unactivated platelets, rap1B was present in the 100,000 x g supernatant fraction. In contrast, in platelets activated with 1 unit/ml alpha-thrombin or with the calcium ionophore, A23187, rap1B was quantitatively recovered in the 10,000 x g cytoskeleton fraction. rap1B was absent from the 100,000 x g fraction containing the membrane skeleton and could not be detected in the 100,000 x g supernatant containing cytosolic proteins and solubilized membrane components. These results indicate that rap1B associates with the cytoskeleton during cell activation.     

Age specific trends in asthma mortality in England and Wales, 1983-95: results of an observational study.

OBJECTIVE: To determine trends in asthma mortality by age group in England and Wales during 1983-95. DESIGN: Observational study. SETTING: England and Wales. SUBJECTS: All deaths classified as having an underlying cause of asthma registered from 1 January 1983 to 31 December 1995. MAIN OUTCOME MEASURE: Time trends for age specific asthma deaths. RESULTS: Deaths in the age group 5-14 years showed an irregular downward trend during 1983-95; deaths in the age groups 15-44, 45-64, and 65-74 years peaked before 1989 and then showed a downward trend; and deaths in the age group 75-84 years peaked between 1988 and 1993 and subsequently dropped. Trends were: age group 5-14 years, 6% (95% confidence interval 3% to 9%); 15-44 years, 6% (5% to 7%); 45-64 years, 5% (4% to 6%); 65-74 years, 2% (1% to 3%). Deaths in the 75-84 and 85 and over categories plateaued. CONCLUSIONS: There are downward trends in asthma mortality in Britain, which may be due to increased use of prophylactic treatment.     

Epidemiology of Haemophilus influenzae type b invasive disease in Wales.

OBJECTIVE--To investigate the epidemiology of invasive disease due to Haemophilus influenzae type b, the clones responsible, and the antibiotic resistance of the isolates. DESIGN--Prospective population based analysis of clinical and epidemiological data collected for Gwynedd during 1980-90 and in the whole of Wales during 1988-90. SETTING--19 hospitals in Wales; all medical microbiology laboratories in Wales participated. PATIENTS--82 patients with confirmed invasive infections caused by H influenzae type b in Gwynedd during 1980-90 and 207 in Wales during 1988-90. MAIN OUTCOME MEASURES--Clinical and epidemiological measures; analysis of the clonal types of the isolates based on the electrophoretic mobilities of 17 metabolic enzymes; and antibiotic resistance. RESULTS--The annual incidence of H influenzae type b infections in Gwynedd was 3.2 cases/100,000 and in Wales was 2.5 cases/100,000. Most cases occurred in children aged under 5 years, the highest annual incidence being in those aged under 1 (84.6/100,000 and 56.9/100,000 in Wales). The cumulative risk of acquiring H influenzae type b disease by the fifth birthday was one in 456 in Gwynedd and one in 578 in Wales. Fifteen per cent of cases in Gwynedd and 7% of those in Wales occurred in adults. Predominant clinical conditions were meningitis in children and pneumonia in adults. In Gwynedd 2/70 (3%) children and 5/12 (42%) adults died. Long term neurological sequelae occurred in 8% (4/48) of children who survived haemophilus meningitis. Children presenting with infection were usually the youngest members of their family. No secondary household cases were identified. 100 of 128 (78%) strains were of a single clone, electrophoretic type 12.5, and 4/207 (1.9%) isolates from Wales were resistant to both ampicillin and chloramphenicol. CONCLUSIONS--The annual rate of infection in children aged under 5 in four Welsh counties was 12-44% higher than that previously published for the United Kingdom. The study emphasises the potential value of a vaccine effective in early infancy and provides baseline data to assess its efficacy after its introduction. Alternatives to ampicillin and chloramphenicol should be used as first line, empirical treatment for severe infections that might be caused by H influenzae type b in Wales.     

Gray wolf density and its association with weights and hematology of pups from 1970 to 1988.

We examined weights and hematologic profiles of gray wolf (Canis lupus) pups and the associated wolf density in the east-central Superior National Forest of northeastern Minnesota (USA) during 1970 to 1988. We collected weight and hematologic data from 117 pups (57 females, 60 males) during 1 September to 22 November each year. The wolf density (wolves/800 km2) trend was divided into three phases: high (72 +/- 7), 1970 to 1975; medium (44 +/- 2), 1976 to 1983; and low (27 +/- 2), 1984 to 1988. Wolf numbers declined (P = 0.0001) 39 and 63% from 1970 to 1975 to 1976 to 1983 and from 1970 to 1975 to 1984 to 1988, respectively. Weight was similar between male and female pups and did not vary as wolf density changed. Mean hemoglobin (P = 0.04), red (P = 0.0001) and white blood cells (P = 0.002), mean corpuscular volume, mean corpuscular hemoglobin concentration and mean corpuscular hemoglobin (P = 0.0001) did differ among the multi-annual phases of changing wolf density. Weight and hematologic data also were compared to values from captive wolf pups. The high, but declining wolf density was associated with macrocytic, normochromic anemia in wolf pups, whereas the lowest density coincided with a hypochromic anemia. Although hematologic values show promise for assessing wolf pup condition and wolf population status, they must be used cautiously until data are available from other populations.