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Prenatal alcohol exposure results in a spectrum of behavioral, cognitive, and morphological abnormalities collectively referred to as fetal alcohol spectrum disorder (FASD). FASD presents with significant phenotypic variability and may be modified by gestational variables such as maternal nutritional status. Iron serves a critical function in the development of and processes within central nervous system (CNS) structures. Gestational iron deficiency alters CNS development and may contribute to neurodevelopmental impairment in FASD. This review explores the relationship between iron deficiency and fetal alcohol spectrum disorder as described in small animal and human studies. Consideration is given to the pathophysiologic mechanisms linking iron homeostasis and prenatal alcohol exposure. Existing data suggest that iron deficiency contributes to the severity of FASD and provide a mechanistic explanation linking these two conditions.

Since the 1960s, the stable isotopes oxygen-18 and deuterium have become widely used for delineating sources and timing of precipitation, identifying effects of evaporation and apportioning end-member contributions in streamflow and groundwater. During the last decade, the development of cavity ring-down spectroscopy has revolutionized monitoring by allowing rapid, relatively inexpensive analyses of large numbers of samples. This paper reviews the use of water isotopes together with other parameters, particularly chloride (a conservative solute) and temperature, to delineate sources and timing of recharge in (1) regional sedimentary aquifer systems and (2) mountainous karst terrains. Case (1) studies focus on spatial variability in recharge, with implications for delineating diffuse versus focused recharge to surficial aquifers, paleorecharge to deep aquifers and sources of salinization. Case (2) studies focus on temporal variability in individual spring basins, which may be particularly susceptible to climate change, and identify recharge at event to seasonal time scales.

ObjectiveFovea-involving subretinal haemorrhage is challenging to manage with uncertain visual outcomes. We reviewed outcomes of patients with fovea-involving macular haemorrhage treated with pars plana vitrectomy (PPV) and subretinal tissue plasminogen activator (tPA) with pneumatic displacement.Methods and AnalysisThis is a retrospective interventional case series. All patients with submacular haemorrhage who underwent PPV with subretinal tPA injection were included. Reasons for exclusion encompassed patients who underwent intravitreal tPA injection in the office without surgery, insufficient follow-up or documentation. Primary outcomes of interest were postoperative visual acuity (VA) at month 1 and 3. Secondary outcomes were median VA at month 3 by location of haemorrhage and underlying diagnosis.ResultsThirty-seven total patients were included. The mean age was 68.2 years, with 54.1% (20/37) females. The most common aetiology was exudative macular degeneration (43.2%), followed by undifferentiated choroidal neovascularisation (CNV) (18.9%), polypoidal choroidal vasculopathy (18.9%), traumatic CNV (10.8%), macroaneurysm (5.4%) and proliferative diabetic retinopathy (2.7%). Median preoperative VA was 20/2000, postoperative month 1 was 20/347 (pConclusionsPPV with subretinal tPA injection and pneumatic displacement of submacular haemorrhage offers modest visual recovery for a diverse group of patients. Location of haemorrhage or specific diagnosis may not predict outcome.

To remediate persistent groundwater uranium contamination in the 300 Area of the Hanford Site, located in southeast Washington State, U.S.A., approximately 7 million liters of polyphosphate solutions (mixture of 90% orthophosphate and 10% pyrophosphate) were delivered in high concentrations to the vadose zone and top of the aquifer over a 13-day period via infiltration and injection. The persistence of uranium in the aquifer is attributed to leaching of residual uranium contamination from the vadose zone by periodic rewetting due to fluctuating water table controlled by daily and seasonal variations of nearby Columbia river stage. The remedy relies on in-situ availability of Ca2+, primarily from cation-exchange and dissolution of carbonate mineral phases, to form calcium phosphate (Ca-P) bearing precipitates that incorporate and adsorb available uranium and form a relatively insoluble coating on sediments thereby reducing the dissolution of residual uranium bearing mineral phases. During injection and infiltration some dissolution of mineral phases is expected to occur along with rapid nucleation of Ca-P and the resulting precipitates are likely to incorporate components from the dissolving phases. The phosphate loading following treatment is calculated to be about 1000–2500 μg/g of sediment surface exposed. Of this amount, approximately 50–650 μg/g is associated with the solid phase that is extractable with acetic acid indicating association with carbonate phase. The observations at the monitoring wells during remedy implementation indicate an initial decrease in pH and an increase in dissolved uranium concentration with delayed breakthrough of phosphate due to reactions with mineral surfaces. Following the initial breakthrough, as the phosphate concentrations increase the uranium concentrations show a sharp decline and then remain low afterwards. Comparison of total uranium concentration profiles from collocated pre- and post-treatment borehole sediment samples indicate limited uranium leaching to the aquifer. The total uranium concentrations remained within the range of variability expected in the field. Sequential extraction tests conducted on sediment samples indicate that prior to treatment uranium is associated primarily with crystalline oxides of iron and clay minerals and to a lesser extent with carbonate minerals. In the post-treatment samples, appreciable reduction in uranium fraction associated with crystalline oxides of iron and clay minerals is observed indicating that uranium has been remobilized due to mineral dissolution, which later complexed with Ca-P-carbonate phases. The formation of surface complex of calcium-carbonate-phosphate likely structurally incorporated or surface adsorbed any available uranium in solution. Surface complexation with oxyhydroxides of iron (and other trace metals) also occurred. To evaluate the significant reactions resulting from introduction of phosphate bearing solutions a reactive transport model is developed to simulate the infiltration event. The results indicate that the extent of HPO42− reaction front is a net result of several reactions. As HPO42− is added to the sediments, the resulting deprotonation reactions lead to excess H+ and pH reduction that are buffered via surface complexation reactions and mineral phase dissolution. The cycle of deprotonation followed by consumption of H+ will continue as long as supply of both phosphate and reacting iron oxyhydroxide surfaces and minerals, primarily uranium bearing carbonates, uranium silicates, and calcite, are maintained. Due to excess supply, the phosphate will react with the available calcium (primarily from ion-exchange reactions) and start forming Ca-P bearing precipitates. In this process, any uranium in the solution will adsorb or get bound to forming precipitate and be sequestered.

Purpose: To report a case of release of vitreomacular traction (VMT) in a patient with a full thickness macular hole (FTMH) immediately following pneumatic vitreolysis (PV) combined with head bobbing movements. Methods: A 71-year-old female with VMT and an FTMH presented with blurred vision for 2 months to the level of 20/400. At her 1-month follow-up visit, PV was performed using C3F8 gas and she was instructed to perform the drinking bird technique for ten minutes. Results: Optical coherence tomography performed ten minutes after PV with head bobbing showed VMT release and a smaller FTMH. Visual acuity improved to 20/150 immediately afterwards and to 20/80 two months later. Conclusions: Using the drinking bird technique for a continuous period of time immediately following PV may encourage rapid VMT release. PV may be a feasible option for patients with VMT and FTMH who do not want surgery.

Purpose To review the clinical radiographic and histopathologic findings associated with orbital glial heterotopia. Methods A literature search in PubMed and Scopus was performed to include all articles published in English between 1980 and January 1, 2019. A case series including 29 case reports of 29 patients, as well as the authors' 2 cases, were considered in the literature review. Results The majority of the cases had onset of symptoms (86%) and age at presentation (71%) before 5 years of age. The most common presenting symptoms and signs were swelling (45%), strabismus (32%), and proptosis (26%). The most common lesion locations described were inferolateral (19%) or primarily posterior orbital or apical (19%). The most common findings associated with orbital glial heterotopia were microphthalmia (10%) and anophthalmia (6%); however, the majority did not have systemic abnormalities (71%). The most common imaging modality was CT scan (71%). Diagnosis was made with histologic analysis in all cases, and confirmed after subtotal resection (35%), total resection (39%), or incisional biopsy (26%). The majority of the cases report no growth on repeat imaging, with only 3 reports of recurrence. Conclusions Glial heterotopia in the orbit is a rare clinical entity most commonly presenting in children. We present 2 cases of orbital glial heterotopia in adults, with a literature on these lesions in both the pediatric and adult populations. Surgeons and pathologists should be aware of this atypical presentation in adulthood. Biopsy is required for diagnosis but is not without risk. Prognosis is generally favorable.Orbital glial heterotopia, commonly considered a rare congenital lesion generally presenting in children, may first become symptomatic in adulthood. Biopsy is required for diagnosis, with symptoms and prognosis dependent on location and growth of the lesion.

Model-based decision making is commonly used in performance assessments to assure water resource protection for both human health and the environment for hundreds of years into the future. To make decisions regarding aquifer protection against potential contamination, a conceptual site model (CSM) describing the hydrodynamic behavior needs to account for subsurface heterogeneities in sufficient detail. When site-specific data are sparse, larger-scale geologic descriptions are adopted with the consequence of losing small-scale features (at the cm scale) that can control contaminant transport. In this study, a multiple lines of evidence approach is used to construct vadose zone CSMs based on an evaluation of several types of data, including geologic logs, borehole moisture content and concentration data, geophysical spectral gamma logging data, and groundwater concentration data for a tank farm at the Hanford Site in southeastern Washington State. The resulting CSMs of the unsaturated zone represent a synthesis of what is known about flow and transport processes at the site-scale and maintain consistency with knowledge that has been accumulated at the regional scale. Through a process of extensive data analyses, a systematic approach is described to create an evidence base that supports the evaluation and development of CSMs. Numerical models are then used to evaluate the impact that smaller-scale heterogeneities have on contaminant transport through the vadose zone for a performance assessment on waste tank closure. Together, the field data and the numerical experiments suggest that although small-scale features close to source releases can have an impact on horizontal spreading, overall there is a relatively minor impact on transport for the site under study as evaluated by differences in peak fluxes and arrival times for historical leak events, and for potential releases resulting from waste tank closure. Use of alternative CSMs, developed through careful examination of available characterization and monitoring data, provides confidence that geologic heterogeneities do not impact contaminant transport behavior significantly enough to alter the assessment of risk for closure at this site.

Aim: In this study, we aimed to evaluate the stress distribution on maxilla, mandible, and glenoid fossa after application of Class III intermaxillary anteroposterior orthopedic forces of 150, 250, and 400 gas applied to a three-dimensional (3D) model of the young human dry skull. Methods: A 3D finite element model was developed from the computed tomography images of a growing boy (age, 13 years). ANSYS (version 16.0) software used to simulate Class III force of progressively increasing intensity over maxilla, mandible, and glenoid fossa to quantify the biomechanical reaction with two components, direction and stress. Results: We quantified detailed changes in the maxillofacial sutures, dentition, mandible, and glenoid fossa with bone-anchored maxillary protraction (BAMP) to analyze their effects. Conclusions: As the force increases from 150, 250 to 400 g, stresses are increased on all structures associated except maxillary central incisor which show a decrease in the stresses. Although forces were for maxillary protraction, stress generated at the circummaxillary sutures was minimal. As with any other Class III force, stresses were distributed on whole of condyle, capsular ligament, and minimal at glenoid fossa. This suggests that BAMP has more of mandibular restraining effect.

Objective: Skeletal class II malocclusion is commonly seen in the Indian clinical scenario among the growing population. In the background of newer functional appliances in recent times, Twin block and Bionator still remain widely used in clinical practice. Thus, a prospective clinical trial was designed to study various skeletal and dental effects of these appliances, as well as changes that occur in the control population. Materials and Methods: A sample size of 30 growing individuals with an age range of 9–14 years, showing class II division 1 malocclusion were selected. They were divided into three groups of 10 patients each, of which 10 were controls and 10 patients each for twin block and bionator groups. The average treatment duration was 6 months. Lateral cephalograms were taken before and after the treatment with functional appliances, and selected parameters were compared. Results: There were considerable skeletal and dental changes brought about by both the appliances when compared with controls, however, there were no significant differences in changes brought about by both the appliances when compared with each other. Conclusion: Both Twin block and Bionator appliances can be effectively used for the correction of skeletal class II malocclusion in growing individuals.

Vadose zone hydrology plays a key role on moisture flow and contaminant migration through the vadose zone to the underlying aquifer. In particular, vadose zone residence times are significantly impacted by the geologic media heterogeneities, physical and hydraulic properties of sediments, and the moisture content of sediments. This is especially true for the relatively low moisture contents (e.g., less than 10% volumetric) that are typical of dry semi-arid conditions such as those existing for Hanford sediments in southeastern Washington, USA. The objectives of this article are to present a detailed assessment and an evaluation of the technical basis for selection of the vadose zone conceptual model for a waste disposal facility at the DOE Hanford Site. Specifically, we provide a detailed description and an assessment of the vadose zone modeling used in Environmental Restoration Disposal Facility (ERDF). The ERDF is a shallow near-surface disposal facility that is situated in the Central Plateau portion of the Hanford Site. The current disposal area is approximately 1000 m long, 400 m wide, with a depth of 22 m. As of middle of year 2015, approximately 14 million metric tons of waste had been disposed at ERDF, which occupies approximately 6.5 million m3 of volume.

Aims and MethodCore features of New Ways of Working include concentrating on service users with complex needs, acting in a consultative role and carrying out interventions that are timely rather than routine. In this service-mapping exercise a retrospective analysis of 150 case notes was performed to evaluate clinical activity in general adult out-patient clinics and to attempt to measure the complexity of the workload.ResultsAnalysis of care programme approach (CPA) level revealed that 40% of patients were not on CPA and 16% of patients were on enhanced CPA. Only a third of the sample had a non-medical care coordinator. Absolutely no changes were made to the management plan in around half of the sample. A minority of patients needed to be seen acutely, within a month, or had their appointment brought forward.Clinical ImplicationsCurrent out-patient activity of consultant teams does not appear to be consistent with New Ways of Working. Psychiatrists will be required to reflect on their roles in out-patient clinics to avoid ‘routine’ appointments and to use their time more efficiently.

The evaluation studies of the proposed repository for long-term storage of spent nuclear fuel and high-level nuclear waste at Yucca Mountain, Nevada, are underway. Fulfillment of the requirements for limiting dose to the public, which includes containment of the radioactive waste emplaced in the proposed repository and subsequent slow release of radionuclides from the Engineered Barrier System (EBS) into the geosphere, will rely on a robust waste container design, among other EBS components. Part of the evaluation process involves sensitivity studies aimed at elucidating which model parameters contribute most to the waste package and overlying drip shield degradation characteristics. The model parameters identified for this study include (1) general corrosion rate parameters and (2) stress corrosion cracking (SCC) parameters. Temperature dependence and parameter uncertainty are evaluated for the general corrosion rate model parameters while for the SCC model parameters, uncertainty treatment of stress intensity factor, crack initiation threshold, and manufacturing flaw orientations are evaluated. Based on these evaluations new uncertainty distributions are generated and recommended for future analyses. Also, early waste package failures due to improper heat treatment were added to the waste package degradation model. The results of these investigations indicate that the waste package failure profiles are governed by the manufacturing flaw orientation model parameters.

The structural features of the PDZ1 domain of the synapse-associated protein SAP90 have been characterized by NMR. A comparison with the structures of the PDZ2 and PDZ3 domains of SAP90 illustrates significant differences, which may account for the unique binding properties of these homologous domains. Within the postsynaptic density, SAP90 functions as a molecular scaffold with a number of the protein-protein interactions mediated through the PDZ1 domain. Here, using fluorescence anisotropy and NMR chemical shift analysis, we have characterized the association of PDZ1 to the C-terminal peptides of the GluR6 subunit of the kainate receptor, voltage-gated K+ channel Kv1.4, and microtubule-associate protein CRIPT, all of which are known to associate with SAP90. The latter two, which possess the consensus sequence for binding to PDZ domains (T/S-X-V-oh), have low micromolar binding affinities (1.5–15 μm). The C terminus of GluR6, RLPGKETMA-oh, lacking the consensus sequence, binds to PDZ1 of SAP90 with an affinity of 160 μm. The NMR data illustrate that although all three peptides occupy the binding groove capped by the GLGF loop of PDZ1, specific differences are present, consistent with the variation in binding affinities.

Recent studies have demonstrated that kainate receptors are associated with members of the SAP90/PSD-95 family (synapse-associated proteins (SAPs)) in neurons and that SAP90 can cluster and modify the electrophysiological properties of GluR6/KA2 kainate receptors when co-expressed in transfected cells. In vivo, SAP90 tightly binds kainate receptor subunits, while SAP97 is only weakly associated, suggesting that this glutamate receptor differentially associates with SAP90/PSD-95 family members. Here, green fluorescent protein (GFP)-tagged chimeras and deletion mutants of SAP97 and SAP90 were employed to define the molecular mechanism underlying their differential association with kainate receptors. Our results show that a weak interaction between GluR6 and the PDZ1 domain of SAP97 can account for the weak association of GluR6 with the full-length SAP97 observed in vivo. Expression studies in HEK293 cells and in vitro binding studies further show that although the individual Src homology 3 and guanylate kinase domains in SAP97 can interact with the C-terminal tail of KA2 subunit, specific intramolecular interactions in SAP97 (e.g. the SAP97 N terminus (S97N) binding to the Src homology 3 domain) interfere with KA2 binding to the full-length molecule. Because receptor subunits are known to segregate to different parts of the neuron, our results imply that differential association of kainate receptors with SAP family proteins may be one mechanism of subcellular localization.

Two extensive plumes (combined area .1000 km 2 ) have been delineated within the Ogallala aquifer in the Southern High Plains, TX, USA. Salinity varies within the plumes spatially and increases with depth; Cl ranges from 50 to .500 mg l 21 . Variable-density flow modeling using SUTRA has identified three broad regions of upward cross-formational flow from the underlying evaporite units. The upward discharge within the modeled plume area is in the range of 10 24 ‐10 25 m 3 day 21 , and the TDS concentrations are typically .3000 mg l 21 . Regions of increased salinity, identified within the Whitehorse Group (evaporite unit) underlying the Ogallala aquifer, are controlled by the structure and thickness variations relative to the recharge areas. Distinct flow paths, on the order of tens of km to .100 km in length, and varying flow velocities indicate that the salinization of the Ogallala aquifer has been a slow, ongoing process and may represent circulation of waters recharged during Pleistocene or earlier times. On-going pumping has had negligible impact on the salinity distribution in the Ogallala aquifer, although simulations indicate that the velocity distribution in the underlying units may have been affected to depths of 150 m after 30 years of pumping. Because the distribution of saline ground water in this region of the Ogallala aquifer is heterogeneous, careful areal and vertical characterization is warranted prior to any well-field development. q 2000 Elsevier Science B.V. All rights reserved.

An extensive saline plume (>250 km 2 ) within the regionally important unconfined aquifer in the Neogene Ogallala Formation overlies the Panhandle oil and gas field in the Southern High Plains, Texas, USA. Relative to upgradient Ogallala water, the plume waters have d 18 O( ˇ6.7 toˇ8.8-) and d D( ˇ42 toˇ88-) values that tend to be depleted and have higher Cl (>150 mg/l) and SO4 (>75 mg/l) concentrations. Various end-member-mixing models suggest that the plume composition reflects the presence of paleowaters recharged during Middle to Late Wisconsinan time rather than salinization associated with petroleum production. Paleowaters probably mixed with salt-dissolution zone waters from the underlying Upper Permian formations before discharging upward into the Ogallala Formation. Cross-formational discharge is controlled primarily by the geometry of the underlying units, as influenced by the Amarillo uplift, pinch-out of the laterally adjoining confined aquifer in the Triassic Dockum Group, variations in the saturated thickness of the Ogallala aquifer and the presence of potential pathways related to salt dissolution. # 2000 Elsevier Science Ltd. All rights reserved.

The insulin-like growth factor-1 (IGF-1)/receptor tyrosine kinase recently has been shown to mediate neuronal survival and potentiate the activity of specific calcium channel subtypes; survival requires Akt, a serine/threonine kinase. We demonstrate here that Akt mediates the IGF-1-induced potentiation of L channel currents, but not that of N channels. Transient expression of wild-type, dominant–negative, and constitutively active forms of Akt in cerebellar granule neurons causes, respectively, no change in IGF-1/L channel potentiation, complete inhibition of potentiation, and a dramatic increase in basal L currents accompanied by the loss of ability to induce further increases. In no case is the IGF-1 potentiation of N currents affected. We additionally find that IGF-1 partially mediates granule neuron survival via L channel activity and that Akt-dependent L channel modulation is a necessary component. Interestingly, very brief exposure (1 min) to IGF-1 triggers nearly complete survival and requires L channel activity. These results strongly suggest that neuronal receptor tyrosine kinases can control long-term calcium-dependent processes via the rapid control of voltage-sensitive channels.

Biological effects of many hormones and cytokines are mediated through receptor-associated Jak tyrosine kinases and cytoplasmic Stat transcription factors, including critical physiological processes such as immunity, reproduction, and cell growth and differentiation. Pharmaceuticals that control Jak-Stat pathways are therefore of considerable interest. Here we demonstrate that a single Jak-Stat pathway can be activated by aurintricarboxylic acid (ATA), a negatively charged triphenylmethane derivative (475 Da) with anti-apoptotic properties. In prolactin (PRL)-dependent Nb2 lymphocytes, ATA sustained cell growth in the absence of hormone and mimicked rapid PRL-induced tyrosine phosphorylation of Jak2 and activation of Stat5a and Stat5b with tyrosine phosphorylation, heterodimerization, DNA binding, and induction of the Stat5-regulated pim-1 protooncogene. ATA also mimicked PRL activation of serine kinases ERK1 and ERK2. However, unlike PRL, ATA did not regulate Stat1 or Stat3. ATA also did not affect Jak3, which is activated in these cells by interleukin-2 family cytokines. Although the mechanism and specificity by which ATA activates Jak2, Stat5, and ERKs in Nb2 cells are still unclear, the present study demonstrates that certain hormone or cytokine effects on Jak-Stat pathways can be discretely imitated by a low molecular weight, non-peptide pharmaceutical. The results are also consistent with Stat5 involvement in lymphocyte growth and survival.

Engaging adolescents is one of many challenges facing Child and Adolescent Mental Health Services today. However, taking advantage of the technology available can bring professionals a step closer to their patients by providing an alternative means of interaction. In this article we explore the use of e-mail as a method of engaging adolescents. The advantages and disadvantages of e-mailing patients are discussed along with recommendations for its safe use.

IntroductionCompeting theories on the aetiology of eating disorders originate from a diverse set of disciplines. One such discipline is Evolutionary Psychology which assumes that the human mind has been shaped by natural and sexual selection. Most evolutionary theories on eating disorders limit themselves to the causation of anorexia nervosa only. The Sexual Competition Hypothesis (SCH), based on the Darwinian theory of sexual selection, provides an explanatory framework for the whole spectrum of eating disorders. It contends that intense female intrasexual competition (ISC) is the ultimate cause of eating disorders. The SCH explains the phenomenon of the pursuit of thinness as an adaptation to ISC in the modern environment. It argues that eating disorders are pathological phenomena that arise from the mismatch between the modern environment and the inherited female adaptations for ISC.ObjectivesTo test predictions from a novel evolutionary hypothesis for eating disorders.Aimsi)To examine the relationship between disordered eating behaviour (DEB) and ISC in a sample of female undergraduates.ii)To establish whether there is any relationship between DEB and Life History (LH) strategy.MethodsA group of 206 female undergraduates were recruited. A structural equation model was constructed to analyse the data.ResultsISC for mates was significantly associated with DEB, as predicted by the SCH. DEB was found to be predicted by fast LH strategy, which was only partially mediated by the SCH.ConclusionsThe results of this study are supportive of the SCH and justify research on a clinical sample.

Exogenously delivered antigenic peptides complexed to heat shock proteins (HSPs) are able to enter the endogenous Ag-processing pathway and prime CD8+ CTL. It was determined previously that a hybrid peptide containing a MHC class I-binding epitope and HSP70-binding sequence Javelin (J0) in complex with HSP70 could induce cytotoxic T cell responses in vivo that were more robust than those induced by the minimal epitope complexed with HSP70. The present study introduces a novel, higher-affinity HSP70-binding sequence (J1) that significantly enhances binding of various antigenic peptides to HSP70. A competition binding assay revealed a dissociation constant that was 15-fold lower for the H2-Kb OVA epitope SIINFEKL-J1 compared with SIINFEKL-J0, indicating a substantially higher affinity for HSP70. Further, modifying the orientation of the hybrid epitope and introducing a cleavable linker sequence between the Javelin and the epitope results in even greater immunogenicity, presumably by greater efficiency of epitope processing. The enhanced immunogenicity associated with Javelin J1 and the cleavable linker is consistently observed with multiple mouse and human epitopes. Thus, by creating a series of epitopes with uniform, high-affinity binding to HSP70, successful multiple epitope immunizations are possible, with equal delivery of each antigenic epitope to the immune system via HSP70. These modified epitopes have the potential for creating successful multivalent vaccines for immunotherapy of both infectious disease and cancer.

A well-accepted vaccination schedule for preterm babies is not available. We therefore studied the response to hepatitis B vaccine in preterm babies.60 babies born to HBsAg-negative mothers were studied. Group I (n=20) consisted of term babies with birth weight2.5 Kg, group II (n=20) included preterm babies with birth weight between 1.8 and 2.49 Kg, and group III (n=20) included preterm babies with birth weight between 1.2 and 1.79 Kg. Mean gestational age in the three groups was 38.5 (1.1), 33.5 (1.4) and 32.7 (2.1) weeks, respectively. All babies received 3 doses (10 microg/0.5 mL) of a recombinant HBV vaccine within 3 days of birth, and at 6 weeks and 6 months of life. Anti-HBs levels were measured one month after the 2nd and 3rd doses each; the immune response was categorized as good responders (anti-HBs100 mIU/mL, low responders (anti-HBs 10-100 mIU/mL) and non-responders (anti-HBs10 mIU/mL).Good antibody response after the second dose was seen in 95% of babies in group I, 60% of those in group II and 10% of those in group III. This increased to 100%, 90% and 45%, respectively after the third dose. The response was influenced by gestational age (r=0.73); 94% of babies with gestational age 34-36 weeks attained good antibody response compared to only 55% of babies with gestational age of 31-33 weeks. Birth weight had no independent influence on the antibody response.The response to hepatitis B vaccine is influenced by gestational age. Hence, in preterm babies, it is advisable to check antibody titers one month after the third dose to assess the need for a booster dose.

This report details the use of a self-expanding metallic stent (SEMS) in the relief of an ischaemic stricture at a gastro-jejunostomy in a patient who was unfit for surgical intervention. Good initial results are reported, along with satisfactory long-term follow-up. A brief discussion of the current relevant literature is also included.

The structural features of the PDZ1 domain of the synapse-associated protein SAP90 have been characterized by NMR. A comparison with the structures of the PDZ2 and PDZ3 domains of SAP90 illustrates significant differences, which may account for the unique binding properties of these homologous domains. Within the postsynaptic density, SAP90 functions as a molecular scaffold with a number of the protein-protein interactions mediated through the PDZ1 domain. Here, using fluorescence anisotropy and NMR chemical shift analysis, we have characterized the association of PDZ1 to the C-terminal peptides of the GluR6 subunit of the kainate receptor, voltage-gated K(+) channel Kv1.4, and microtubule-associate protein CRIPT, all of which are known to associate with SAP90. The latter two, which possess the consensus sequence for binding to PDZ domains (T/S-X-V-oh), have low micromolar binding affinities (1.5-15 microm). The C terminus of GluR6, RLPGKETMA-oh, lacking the consensus sequence, binds to PDZ1 of SAP90 with an affinity of 160 microm. The NMR data illustrate that although all three peptides occupy the binding groove capped by the GLGF loop of PDZ1, specific differences are present, consistent with the variation in binding affinities.