Left atrial spontaneous echo contrast in asymptomatic patients with a mechanical valve prosthesis

BACKGROUND

Valve thromboembolism may be a fatal complication of mechanical valve prosthesis if detected late. Spontaneous echo contrast (SEC) is a well-documented prothrombotic phenomenon; here we report it in asymptomatic patients with a mechanical valve prosthesis.

METHODS

Ninety-two asymptomatic patients with a mechanical valve prosthesis for underlying rheumatic heart disease underwent transesophageal echocardiography. Appendage area, peak filling and emptying velocities of the left atrial appendage, and the presence or absence of SEC and thrombi were determined. The results of 56 patients without SEC or thrombi (group I) were compared with those of 24 patients with SEC and no thrombi (group II) and 12 patients with thrombi (group III).

RESULTS

Spontaneous echo contrast was present in 39% of the asymptomatic patients with a mechanical valve prosthesis. Although 12 patients had cardiac thrombi, including valve thrombi in 4, no patients presented symptoms. Anticoagulant therapy had no significant association with SEC and atrial thrombi. There was a significantly greater prevalence of atrial fibrillation and mitral prosthesis in groups II and III than in group I. Two patterns of left atrial appendage flow were identified: one was organized biphasic flow with peak filling velocities of 41.2 +/- 17.2 cm/s and emptying velocities of 40.5 +/- 17.5 cm/s. The other showed irregular, very low peak filling velocities (104 +/- 11.5 cm/s) and emptying velocities (12.3 +/- 13.1 cm/s). The former flow pattern was associated with sinus rhythm and the latter form was associated with atrial fibrillation.

CONCLUSIONS

There was a relatively high prevalence of SEC and thrombi in patients with a mechanical valve prosthesis. Patients with a valve prosthesis may not have clinical symptoms. Anticoagulation intensity was not associated with the occurrence of SEC and thrombi. Patients with the mitral valve prosthesis and atrial fibrillation were identified as a high-risk of subgroup for the development of SEC and thrombi.

K-ras gene mutation is a useful predictor of the survival of early stage colorectal cancers

Mutations in the K-ras gene were found to be of predictive value in the clinical outcome of non-small cell lung cancers, but its role in predicting the survival of colorectal cancer patients is still inconclusive. Point mutations in codon 12 or 13 of K-ras gene were analyzed in 64 colorectal cancers composing 4 Dukes' stage. A, 34 stage B, 21 stage C and 5 stage D. DNA extracted from the paraffin-embedded tissues of the 64 patients was amplified with the polymerase chain reaction and subsequently analyzed by direct cycle sequencing. Thirteen of sixty-four (20%) resected colorectal cancer specimens were found to have K-ras gene mutation at either codon 12 or 13. Log rank tests found that K-ras gene mutation and Dukes' stage were associated with patients' survival. When stratified by Dukes' stage, the patients with mutated K-ras genes in the stratum of stage A or B were found to have shorter survival times than those without mutated K-ras genes (P = 0.003), but this was not the case in the stratum of stages C and D. The relative risk of mortality in the stratum of stage A or B was 7.74 (95% confidence interval: 1.72-34.89) by Cox regression analysis. We thereby conclude that K-ras gene mutation is a usefull predictor of the survival of early stage colorectal cancers.

The 3' untranslated region of coronavirus RNA is required for subgenomic mRNA transcription from a defective interfering RNA

The 3'-end of mouse hepatitis virus (MHV) genomic RNA contains a recognition sequence (55 nucleotides [nt]) required for minus-strand RNA synthesis. To determine whether the 3'-end sequence is also involved in subgenomic mRNA transcription, we have constructed MHV defective interfering (DI) RNAs which contain a chloramphenicol acetyltransferase (CAT) gene placed behind an intergenic sequence and a 3'-end sequence with various degrees of internal deletions. The DI RNAs were transfected into MHV-infected cells, and CAT activities, which represent subgenomic mRNA transcription from the intergenic site, were determined. The results demonstrated that the deletions of sequence upstream of the 350 nt at the 3'-end, which include the 3'-untranslated region (3'-UTR), of MHV genomic RNA did not affect subgenomic mRNA transcription. However, deletions that reduced the 3'-end sequences to 270 nt or less completely abolished the mRNA transcription despite the fact that all of these clones synthesized minus-strand RNAs. These results indicated that mRNA transcription from an intergenic site in the MHV DI RNA requires most of the 3'-UTR as a cis-acting signal, which likely exerts its effects during plus-strand RNA synthesis. A substitution of the corresponding bovine coronavirus sequence for the MHV sequence within nt 270 to 305 from the 3'-end abrogated the CAT gene expression, suggesting a very rigid sequence requirement in this region. The deletion of a putative pseudoknot structure within the 3'-UTR also abolished the CAT gene expression. These findings suggest that the 3'-UTR may interact with the other RNA regulatory elements to regulate mRNA transcription.

Influenza B virus infection associated with shock in a two-month-old infant

Influenza B virus usually causes a mild and self-limiting illness. A 2-month-old infant presented with acute symptoms suggestive of septic shock but recovered after vigorous resuscitation 1 day later. Influenza B was isolated from a throat swab taken from the infant. Bacterial cultures of blood, urine and spinal fluid had no growth. This case illustrates that the clinical signs and symptoms of influenza in infants may be indistinguishable from bacterial sepsis.

Permeation and block of dopamine-modulated potassium channels on rat striatal neurons by cesium and barium ions

1. In cell-attached patch-clamp recordings from freshly dissociated rat caudate-putamen neurons, an 85-pS inwardly rectifying K+ channel, which was previously found to be modulated by D2-like dopamine receptors, was blocked by externally applied BaCl2 or CsCl. 2. At concentrations between 100 and 500 microM, Ba2+ blockade was voltage dependent, with a greater block at hyperpolarized voltages, in a manner consistent with blockade of the channel pore. Single-channel currents were flickery, with intervening periods of more complete blockade, and block appeared to be time dependent, with an estimated electrical distance of 0.24 and an apparent dissociation constant of 205 microM at 0 mV. 3. At concentrations between 1 and 3 mM, Cs+ blockade was similarly voltage dependent, but without periods of longer blockade, with an electrical distance of 0.81 and an apparent dissociation constant of 625 microM at 0 mV. Cs+ could also permeate this channel at voltages near the K+ reversal potential. The current-voltage relationship displayed an anomalous negative slope conductance, in a manner inconsistent with a single-ion pore. 4. Smaller-conductance, dopamine-insensitive channels were blocked more potently by both Ba2+ and Cs+ than was the 85-pS channel, reflecting differences between inwardly rectifying K+ channels mediating resting conductance and those mediating dopamine receptor responses in striatal neurons.

Primary hemangiopericytoma in the axis bone: case report and review of literature

OBJECTIVE AND IMPORTANCE

To the best of our knowledge, this is the first reported case of primary hemangiopericytoma in the axis bone. With this report, we attempt to better characterize this uncommon lesion in the vertebral column.

CLINICAL PRESENTATION

This report describes a case of primary heman-giopericytoma in the axis bone of a 16-year-old female patient who presented with acute torticollis. Her neurological status was unimpaired. A lateral radiograph of the cervical spine demonstrated an odontoid neck fracture and a C1-C2 rotatory deformity. The magnetic resonance imaging study showed a hypodense lesion with moderate enhancement on T1- and T2-weighted images on the dens and body of the axis with an odontoid neck fracture. Reviewing the literature, primary hemangiopericytoma in the spine is rare; 9 cases of hemangiopericytoma with vertebral bone involvement and 44 cases of this tumor with intraspinal meningeal involvement have been reported.

INTERVENTION

The patient was treated with odontoidectomy via the transoral approach, along with posterior fixation using the Halifax clamp. She was followed up 17 months after surgery, and no evidence of tumor recurrence was found.

CONCLUSION

The treatment for osseous hemangiopericytoma is still controversial. At present, adequate surgical removal with postoperative radio-therapy is recommended. In addition, although hemangiopericytoma is rare in the spine, it should be kept in mind in the differential diagnosis of spinal tumors.

Systemic fungal infection in very low-birth-weight infants

This retrospective study was designed to investigate the related factors and outcome of systemic fungal infection in very low-birth-weight (VLBW) infants. Medical records of infants admitted to the neonatal intensive care unit of National Cheng Kung University Hospital between January 1990 and June 1994 were reviewed. Of the 262 VLBW infants, 15 (5.7%) had fungemia (14 Candida 1 Cryptococcus) during the study period. Among the fungemic infants, 60% also had urinary tract infection; 18% had central nervous system infection. Their mean birth weight was 1079 +/- 78 g (504-1474 g), and the gestational age was 28.6 +/- 0.6 weeks (23-32 weeks). Thirteen of them (87%) had respiratory distress syndrome and patent ductus arteriosus, while 60% had chronic lung disease. The percentage of antibiotic usage, parenteral hyperalimentation, endotracheal intubation, placement of central venous line and steroid therapy were 100%, 100%, 73%, 67% and 36% respectively. The mean age at diagnosis of fungemia was 40.5 +/- 4.8 days (10-76 days). Common clinical manifestations were respiratory deterioration (93%), poor feeding (58%) and fever (53%). The frequency of side effects of amphotericin B in decreasing order were: hypokalemia (54%), hyponatremia (31%) and decreased urine amount (23%). The mortality rate was 40%. It was concluded that systemic fungal infection in VLBW infants might result in high mortality and the side effects were high in the treated infants.

Prevalence of Legionella pneumophila infection in children and its role in pediatric community-acquired atypical pneumonia

The infection status of Legionella pneumophila in children and its role in pediatric community-acquired pneumonia were investigated. Because exposure to Legionella pneumophila may be highly variable and there has been no unanimously agreed-upon cut-off values in previous seroprevalence studies, 60 serum samples collected from infants aged 12 to 18 months were examined using immunofluorescence antibody test to determine the cut-off titer which represents past Legionella pneumophila infection. An IFA titer of greater than or equal to 32 was found to be suitable to represent past L. pneumophila infection. A seroepidemiological study of the prevalence of L. pneumophila in 180 children showed the prevalences in children aged 7 to 18 years to be between 28.4 and 35%. Fifty-three paired sera were tested to determine the role of Legionella pneumophila in pediatric, community-acquired, atypical pneumonia. The frequency of confirmed disease was 0% and of presumptive cases was 5.7%. Legionella pneumophila was not a common etiologic agent of pediatric pneumonia in Taiwan.

The etiology of lung cancer in nonsmoking females in Harbin, China

A case-control study of female lung adenocarcinoma in Harbin, China involving interviews with 120 cases of nonsmoking females, matched 1:1 with controls, showed that high coal use, indoor air pollution, exposure to coal dust, frequent frying and deep frying food, and a history of lung cancer in the family were statistically significant risk factors for female adenocarcinoma. High personal income, spacious living quarters, and frequent consumption of carrots were protective factors for adenocarcinoma.

Exfoliation syndrome

Increasing pathophysiologic evidence indicates that exfoliation syndrome, a systemic process involving various visceral organs, frequently manifests itself first in the eyes as exfoliation of the lens and glaucoma. Exfoliation syndrome occurs when several tissues synthesize an abnormal basement membrane protein. This protein may obstruct the trabecular meshwork in the eye and cause glaucoma. We present a case of exfoliation syndrome associated with angle-closure glaucoma in a 57-year-old male patient from Taiwan. After peripheral iridectomy and topical antiglaucoma medications, intraocular pressure in both eyes was well controlled in the range of 15 to 20 mmHg. The mechanism of the glaucomatous optic neuropathy in this patient was probably caused by chronic angle-closure glaucoma superimposed with the exfoliation syndrome.

Heterochromatin (chromosome dots and chromocentres): key to planarian regeneration?

Regenerating planaria were treated with colchicine dissolved in planarian saline solution in order to harvest metaphase chromosomes. Slides containing such chromosomes were incubated in phosphate buffer at high temperature for 2h and stained with Giemsa solution in order to view heterochromatic dots in chromosomes. The chromosomes were found to contain massive regions of dense heterochromatin. In addition, most interphase cells exhibited numerous densely staining chromocentres. Heterochromatin has been postulated to reduce the duration and enhance the speed of the cell cycle, and previous work has implicated heterochromatin in cells undergoing rapid division. These findings imply that the profound regenerative potential of planarians may be due to their high cellular levels of heterochromatin.

A seroepidemiological study of Varicella-Zoster virus in Taipei City

Varicella has been considered a common and benign disease of children. However, adults tend to have severe disease and in some high risk groups, such as neonates and leukemic patients, varicella infection can be fatal. A large-scale seroepidemiological study on varicella was performed to reveal the current varicella infection status and to serve as a prevaccination survey before the possible implementation of vaccination program in Taiwan. This study included a total of 1384 individuals whose ages ranged from newborns to old adults. Enzyme-linked immunosorbent assay was adopted to determine the IgG antibodies against Varicella-Zoster virus. The results showed: (1) only 24% of infants aged birth to three months had maternal antibodies, (2) the seroprevalence increased slowly during the first 3 years after birth, (3) most infections occurred between 3 and 10 years old, (4) 10% (female) to 20% (male) of adults were still susceptible to varicella infection, and (5) 85% of pregnant women had antibodies against VZV. These data suggest that if varicella vaccination is to be done in Taiwan, the appropriate inoculation age would be between 12 and 24 months. Besides, there exists a pool of uninfected adults who potentially will develop severe illnesses once infected and should be screened and protected by varicella vaccines.

Analysis of K-ras gene mutations in periampullary cancers, gallbladder cancers and cholangiocarcinomas from paraffin-embedded tissue sections

Point mutations of the K-ras gene were analyzed in 25 periampullary cancers (21 ampulla vater cancers, two common bile duct cancers and two duodenal cancers), two gallbladder cancers and six cholangiocarcinomas. DNA extracted from the paraffin-embedded tissues was amplified with the polymerase chain reaction and subsequently analyzed by direct cycle sequencing at codons 12, 13 and 18 of the K-ras gene. Codon 61 was first screened with single strand conformation polymorphism and then sequenced by direct cycle sequencing. No point mutation was found in any of the 25 periampullary cancers or the two gallbladder cancers. These results are similar to previous reports. Mutation of the K-ras gene seems not to play an important role in tumorigenesis of periampullary cancer. In two of six (33%) cholangiocarcinoma patients, point mutations were found. Both mutations were transitions, GGT to GAT at codon 12. The incidence of mutation was greater than that in Thailand (about 8%) but less than that in Japan (about 60%). Mutation of the K-ras gene may play varied roles in the tumorigenesis of cholangiocarcinoma, depending on geographic area.

Effects of caffeine on Ca2+ fluxes and secretion in bovine chromaffin cells

The effects of caffeine on Ca2+ fluxes and catecholamine secretion in bovine adrenal chromaffin cells were examined. Caffeine inhibited secretion. 45Ca2+ uptake and cytosolic Ca2+ concentration ([Ca2+]i) rise induced by the nicotinic receptor agonist 1.1-dimethyl- 4-phenylpiperazinium (DMPP) and the Na+ channel activator veratridine. The inhibitory effect of caffeine on high K(+)-induced secretion was smaller than that on DMPP- and veratridine-induced responses. Caffeine only slightly inhibited high K(+)-induced 45Ca2+ uptake and did not affect [Ca2+]i rise. Caffeine also inhibited muscarinic receptor-mediated inositol phosphate generation. Our results suggest that the inhibitory effects of caffeine on bovine chromaffin cells mainly occur at both muscarinic and nicotinic receptors as well as at the voltage-dependent Na+ channels and to a smaller extent at site(s) distal to Ca2+ entry. The effects of caffeine on nicotinic receptors but not on muscarinic receptors can be explained by its ability to raise intracellular cAMP.

Thyroid hormone upregulates gene expression, synthesis and release of pro-epidermal growth factor in adult rat kidney

Attempts were made to elucidate whether thyroid hormone upregulates renal pro-epidermal growth factor (pro-EGF) gene expression, biosynthesis and release in adult rats which were rendered hypothyroid. Predominantly pro-EGF was detected in renal cortex, whereas pro-EGF and its degraded species were found in urine. We demonstrated that T3 increased pro-EGF levels in renal cortex to 2.2 +/- 0.17, 2.37 +/- 0.19, 2.73 +/- 0.25, and 3.10 +/- 0.45 fold within day 1, 2, 4 and 8, respectively following treatment. Immunoreactive EGF, assessed by immunohistochemical methods, was confined in the distal convoluted tubule and thick ascending limb of Henle. T3 markedly enhanced the density of irEGF in these nephrons. T3 augmented the concentration of urinary irEGF to 2.1, 2.2, 2.8 and 3.6 fold within day 1, 2, 4 and 8 and the abundance of urine pro-EGF to 2.53 +/- 1.39, 3.8 +/- 0.70, 3.59 +/- 1.48 fold within day 1, 2, 4, respectively. Moreover, we employed reverse transcriptase/polymerase chain reaction method to analyze relative abundance of pro-EGF mRNA in kidneys of various thyroid states and found T3 markedly increased pro-EGF mRNA levels after treatment of 1, 2 and 4 days. These results indicated that thyroid hormone augmented the gene expression, biosynthesis and excretion of pro-EGF in adult rat kidney.

Outcome and cost of intensive care for very low birth weight infants

Very low birth weights (VLBW) remain the major factor contributing to neonatal mortality and morbidity. The development of Neonatal Intensive Care Units (NICU) has improved the outcome for the VLBW infants. However, outborn VLBW infants may have different outcomes, and different medical costs than those born intramurally. This study compared the mortality, morbidity and costs of inborn and outborn VLBW infants cared in the NICU of a tertiary care center. A total of 176 VLBW infants (inborn 83, outborn 93) were examined over the three years period June 1990 to May 1993. The birth weights (1131 +/- 244 g vs 1133 +/- 255 g) and gestational ages (29.0 +/- 4.0 wk vs 28.9 +/- 3.0 wk) were not different between the two groups. However, the age of admission to our wards was significantly different between the inborn infants (5.0 +/- 3.2 hr.) and outborn infants (53.6 +/- 26.8 hr.). There was no difference in mortality rates between the outborn infants (35.7%) and the inborn infants (32.9%), nor in the incidence of intraventricular hemorrhage, respiratory distress syndrome, sepsis, necrotizing enterocolitis, retinopathy of prematurity or abnormal auditory brainstem response. However the incidence of patent ductus arteriosus and chronic lung disease of the outborn infants was higher than those of the inborn (47% vs 32%, 51% vs 29% respectively). The mean duration of hospitalization and cost seemed to be longer and higher in the outborn VLBW infants. It was concluded that outborn VLBW infants have higher rates of morbidity, longer hospitalization and cost more than inborn infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Refractory fetal supraventricular tachycardia with hydrops: report of one case

Fetal tachycardia sometimes is quite difficult to treat, especially when the fetus has congestive heart failure. Sustained supraventricular tachycardia and hydrops had been diagnosed in a fetus as early as the 27th week of gestational age. A variety of antiarrhythmic agents, including digoxin, digoxin in combination with quinidine or propranolol or verapamil, have been prescribed for the mother, always in a vain effort of conversion of the tachycardia. A baby was born via vaginal delivery at 35 weeks' gestation because of premature labor. The tachycardia disappeared immediately after birth, but several episodes of tachycardia occurred during the neonatal period, and were converted only by electric cardioversion or intravenous amiodarone. Oral amiodarone was then prescribed for three months to prevent recurrence. The baby has lived well without attacks during a one-and-a-half-year follow-up.

Mastoparan activation of dopamine-modulated K+ channels on rat striatal neurons

Coupling mechanisms between a D2-like dopamine receptor and an 85 pS K+ channel on freshly dissociated rat caudate-putamen neurons were studied using cell-attached patch-clamp electrophysiology. Channel currents were observed in the absence of dopamine receptor agonists when mastoparan, an activator of certain guanyl nucleotide binding proteins (G-proteins), was applied via the patch pipette. Channel current-voltage relationships and open probabilities observed with mastoparan were indistinguishable from those obtained with dopaminergic agonists. Alamethicin, which mimics the membrane-perturbing but not the G-protein activating properties of mastoparan, did not activate the channel, suggesting that non-specific effects of mastoparan were unlikely to account for this effect. Our results indicate that coupling between the D2 dopamine receptor and this K+ channel may involve a mastoparan-sensitive G-protein.

Dopamine-modulated potassium channels on rat striatal neurons: specific activation and cellular expression

We have used cell-attached patch-clamp electrophysiology to characterize the activation and distribution of an 85 pS K+ channel on freshly dissociated rat striatal (caudate-putamen) neurons. In recordings from 643 cells, openings of this channel showed an absolute dependence on the presence of dopamine or the D2-like dopamine receptor agonist quinpirole in the cell-attached patch pipette, but were never seen when the D2 antagonist domperidone was applied along with quinpirole, or in the absence of drug. This channel displayed inward rectification at depolarized membrane potentials, but its activation was otherwise voltage insensitive. It was largely restricted to a subset of dissociated cells with diameters > or = 10 microns, with channel openings seen in about 25% of patches. When present, there were typically multiple channels per patch. Cells of this size were immunocytochemically stained for neuron-specific enolase but not glial fibrillary acidic protein; about 40% were also labeled for gamma-amino butyric acid (GABA) and about 60% for NADPH diaphorase, with GABAergic cells displaying a shape most similar to that of cells expressing the channel. A large number of distinct types of other channels were also present, comprising inwardly rectifying channels of 5-35 pS conductance and voltage-activated channels of 100-250 pS, but the frequencies of occurrence and fractional open times of these channels were independent of the presence or absence of dopaminergic agonists. Thus, the 85 pS K+ channel uniquely requires activation by a D2-like dopamine receptor on rat striatal neurons, and is selectively expressed by a subset of these cells, which are most likely to be GABAergic neurons.

Buspirone inhibits contact hypersensitivity in the mouse

We have observed that 8-4-[4-2-pyrimidyl)-1-piperazinyl]butyl]-8-azaspiro [4.5]decane-7.9-dione, an agent commonly known as buspirone HCl, possesses immunosuppressive activity when administered either topically or systemically, as assessed in a mouse model of contact hypersensitivity. Topical or systemic administration of buspirone significantly reduced the tissue swelling and leukocyte infiltration associated with the elicitation phase of contact hypersensitivity. Buspirone is a safe, widely used drug which has a history of use in humans throughout the world. These data demonstrate a previously unknown pharmacologic activity of buspirone.

Cerebellar medulloblastomas: a comparison between adults and children

A retrospective analysis of 19 medulloblastomas in patients aged 2 to 24 years was conducted employing 14 children (<15 years old) and 5 adults. All patients received gross total excision of the tumour with postoperative craniospinal irradiation. The patients were then followed up for more than 5 years. To determine which factors influenced the prognosis of these two age groups, we analysed the differences of the proliferating cell nuclear antigen (PCNA), the degree of tumour invasion and the outcome between adult and childhood medulloblastomas. In summary, medulloblastomas in adults and children had similar cell proliferative activity and long term survival rates but the tumours with brain stem invasion, which commonly occurred in children, had an early recurrence rate and a poor prognosis. The prognosis of medulloblastoma may depend upon the degree of tumour invasion of the brain stem.

Renal effects and urinary excretion of prostaglandin following indomethacin therapy in premature infants with patent ductus arteriosus

Renal side effects and urinary prostaglandin were evaluated in 10 premature infants (Mean +/- SD: BW 1245 +/- 290 gm, GA 32 +/- 2.2 wks, Postnatal age 7.7 +/- 3.8 days) with significant PDA who were given one dose of indomethacin (0.3 mg/kg intravenously). There was a significant decrease in urinary output, osmolal and free water clearance after therapy. The fractional excretion of sodium, chloride, potassium, glomerular filtration rate and urinary prostaglandin E2 also decreased but were not statistically different from the baseline values. In infants who responded to indomethacin with ductus closure, their renal functions appeared to be preserved even though they had higher plasma indomethacin levels than the non-responders in whom significant changes in renal function were observed following indomethacin therapy. This observation suggested that the improved renal hemodynamics following the closure of the ductus may minimize or attenuate the renal side effects of indomethacin.

Identification of the cis-acting signal for minus-strand RNA synthesis of a murine coronavirus: implications for the role of minus-strand RNA in RNA replication and transcription

Minus-strand RNA is the first RNA species made by plus-strand RNA viruses, such as mouse hepatitis virus (MHV), and serves as a template for subsequent RNA replication and transcription. The regulation of minus-strand RNA synthesis has been difficult to study because of the paucity of minus-strand RNA. We have optimized a ribonuclease (RNase) protection assay which enabled the detection of minus-strand RNA synthesis from nonreplicating RNAs, thus clearly separating minus-strand from plus-strand RNA synthesis. We used an MHV defective interfering (DI) RNA containing a chloramphenicol acetyltransferase gene as a reporter to determine the cis-acting signal for MHV minus-strand RNA synthesis. It was found that minus-strand RNAs existed in double-stranded RNA form in the cell. By using various deletion clones, we demonstrated that the cis-acting signal for minus-strand RNA synthesis resides in the 55 nucleotides from the 3' end plus poly(A) tail of the MHV genome. This is much shorter than the 436 nucleotides previously reported for the 3'-end replication signal. No specific upstream MHV sequence was required for the initiation of minus-strand RNA synthesis. This finding suggests that the requirement for minus-strand RNA synthesis is much less stringent than that for genomic and subgenomic plus-strand RNA synthesis and that some of the minus-strand RNAs made may not be functional since they may lack the recognition signals for RNA replication or transcription. We further showed that the DI clones which actively transcribed a subgenomic mRNA from an internal intergenic sequence synthesized much less minus-strand RNA than those clones which did not transcribe subgenomic mRNAs, indicating that minus-strand RNA synthesis was inhibited by transcription from an internal promoter of the same DI RNA. This result also suggests that the regulation of the quantities of subgenomic mRNAs is not at the point of minus-strand RNA synthesis but rather at plus-strand RNA synthesis. Furthermore, the finding that the leader sequence was not required for minus-strand RNA synthesis suggests that the leader RNA regulates mRNA transcription during plus-strand RNA synthesis.

Exponentially tapered t-tube model of systemic arterial system in dogs

This study determines the role of an asymmetric T-tube model as a representation of arterial mechanical properties. The model consists of two non-uniform tubes connected in parallel. The non-uniform properties of each tube include geometric and elastic tapering and each tube terminates in a complex load. Pulsatile pressure and flow velocity of the ascending aorta were measured in 10 closed-chest, anaesthetized dogs. An exponentially tapered transmission line is used to describe the non-uniform properties of the vasculature. The phase constant is a function of position along the path length due to geometric and elastic tapers. This non-uniform T-tube model makes it possible to fit the measured pressure waveform in the ascending aorta. Model parameters could be estimated and used to interpret the physical properties of the arterial system. The mathematical and experimental model impedance spectra are similar. There is a close correspondence between the impedance parameters derived from the non-uniform T-tube model and values computed from measurements on dogs. The results suggest that inclusion of tube tapering improves the mathematical model so that it closely represents the experimentally derived arterial impedance in closed-chest dogs. We conclude that the non-uniform properties of wave-transmission paths may play an important role in governing the behaviour of an asymmetric T-tube for the description of the arterial system.

Coronavirus: how a large RNA viral genome is replicated and transcribed

Coronaviruses are important human and animal pathogens and contain an extraordinarily long (27-31 kb) RNA genome. Its RNA synthesis involves complex mechanisms of regulation, similar to those of DNA viruses. In this treatise, mouse hepatitis virus (MHV) is used as a model for the discussion of the mechanism of viral RNA synthesis. We show that MHV RNA synthesis requires interactions of multiple RNA components, which are likely mediated by protein-RNA and protein-protein, as well as RNA-RNA, interactions. This virus also provides a unique example of a discontinuous transcription mechanism, which involves a trans-acting RNA component. Finally, study of the cis-acting signals for the various steps of RNA synthesis revealed an insight into the regulation of viral RNA synthesis. This discussion suggests that the regulation of RNA synthesis in coronavirus is more complex than previously thought possible for RNA viruses. Coronavirus RNA transcription and replication may serve as a paradigm of RNA synthesis for RNA viruses in general.

Gingival absorption of triclosan following topical mouthrinse application

This study assessed the gingival uptake and urinary excretion of triclosan in dogs following topical applications of a mouthrinse containing 0.03% of triclosan. Five different phases were conducted to define the time course of plasma concentration. The effect of plaque on gingival absorption was also measured. Phase I: Animals' teeth were cleaned of plaque via scraping. Blood sampling time was 0-2 hours. Phase II: Plaque was not removed from the animals' teeth. Blood sampling time was 0-2 hours. Phase III: Plaque was not removed from the animals' teeth. Blood sampling time was 0-6 hours. Phase IV: Plaque was not removed from the animals' teeth. Blood sampling time was 0-12 hours. Phase V: Animals' teeth were cleaned of plaque via scraping. Blood sampling time was 0-12 hours. The test substance was administered to 1 male and 1 female dog in Phases I, II, IV and V, and to 1 male dog in Phase III. The same animals were used in each phase. On the first day of each phase, the animals were treated with distilled water for a 15-minute period. The animals were exposed daily to the test material for a 15-minute period during the remaining 7 days of each phase. The test material was administered using custom-made acrylic applicator trays to enclose the maxillar premolars and molars and gingiva of one-half of the upper jaw. A leak-proof seal along the mucogingival junction and palatal mucosa was established and maintained during the exposure period.(ABSTRACT TRUNCATED AT 250 WORDS)

Multiple sulfonylurea-sensitive potassium channels: a novel subtype modulated by dopamine

In single channel patch-clamp recordings from freshly dissociated rat corpus striatum (caudate-putamen) neurons, the sulfonylurea drugs tolbutamide and glibenclamide caused a concentration-dependent blockade of a K+ channel that is activated by D2 dopamine receptor agonists. Tolbutamide was about 10-100 times more potent than glibenclamide, a rank-order potency opposite to that seen at previously described adenosine triphosphate-sensitive K+ channels. The channel also was poorly activated by diazoxide, which is a known opener of adenosine triphosphate-sensitive K+ channels. However, like adenosine triphosphate-sensitive channels, it opened in the absence of dopaminergic agonist when the cells were treated with the metabolic inhibitor rotenone, indicating that channel openings occur under energy-depleting conditions. This suggests the existence of a novel, pharmacologically distinct class of sulfonyl-urea-sensitive K+ channels, regulated metabolically and also mediating dopaminergic neurotransmission.

Deletion mapping of a mouse hepatitis virus defective interfering RNA reveals the requirement of an internal and discontiguous sequence for replication

All of the defective interfering (DI) RNAs of mouse hepatitis virus (MHV) contain both the 5' and 3' ends of the viral genomic RNA, which presumably include the cis sequences required for RNA replication. To define the replication signal of MHV RNA, we have used a vaccinia virus-T7 polymerase-transcribed MHV DI RNA to study the effects of sequence deletion on DI RNA replication. Following infection of susceptible cells with a recombinant vaccinia virus expressing T7 RNA polymerase, various cDNA clones derived from a DI RNA (DIssF) of the JHM strain of MHV, which is a 3.5-kb naturally occurring DI RNA, behind a T7 promoter were transfected. On superinfection with a helper MHV, the ability of various DI RNAs to replicate was determined. Serial deletions from the middle of the RNA toward both the 5' and 3' ends demonstrated that 859 nucleotides from the 5' end and 436 nucleotides from the 3' end of the MHV RNA genome were necessary for RNA replication. Surprisingly, an additional stretch of 135 nucleotides located at 3.1 to 3.3 kb from the 5' end of the genome was also required. This stretch is discontiguous from the 5'-end cis replication signal and is present in all of the naturally occurring DI RNAs studied so far. The requirement for a long stretch of 5'- and 3'-end sequences predicts that the subgenomic MHV mRNAs cannot replicate. The efficiency of RNA replication varied with different cDNA constructs, suggesting possible interaction between different regions of DI RNA. The identification of MHV RNA replication signals allowed the construction of an MHV DI-based expression vector, which can express foreign genes, such as the chloramphenicol acetyltransferase gene.

The crystal and molecular structure of trichosanthin at 2.6 A resolution

The crystallographic refinement of trichosanthin has been performed at 2.6 A resolution. The crystal and molecular structure of trichosanthin is described in detail in this paper. On summarizing the regularity of the amino acid sequences of eight kinds of ribosome inactivating proteins and combining with the crystal and molecular structure of trichosanthin, fifteen most conservative amino acid residues are analyzed. It is found that four most conservative polar amino acid residues Gln156, Glu160, Arg163 and Glu189 gather on the molecular surface on the boundary of the large and small domains, thus forming the active center of the protein molecule.

The clinical application of transcutaneous bilirubinometry in full-term Chinese infants

The pattern of jaundice in Chinese full-term newborns has seldom been explored. This study was to 1) investigate the correlation between transcutaneous bilirubin indices (TcB) and serum bilirubin levels; 2) use TcB to follow the pattern of jaundice in Chinese full-term newborns; and 3) compare the sensitivity and specificity of TcB measured from the forehead (TcB1), and mid-sternum (TcB2) by receiver operating characteristic curves (ROC curves). From April 1 to August 31, 1989, a total of 3217 TcB were obtained from 305 inborn full-term newborns (male 175, female 130) during their first 6 days of life. The correlation between serum bilirubin levels and TcB measured from the forehead (TcB1) and from the mid-sternum (TcB2) was good (r = 0.82 and 0.86 respectively). For formula-fed infants, both TcB1 (16.3 +/- 3.0) and TcB2 (16.6 +/- 2.7) reached peak levels at 78-84 hours of age, while in mixed-fed infants, peak levels were noted at 54-60 and 84-90 hours for TcB1 (17.2 +/- 2.2) and TcB2 (16.6 +/- 2.6) respectively. The incidence of hyperbilirubinemia was 5.9 per cent. There were no differences in peak TcB levels between formula-fed and mixed-fed infants. The ROC curves suggested that TcB2 is better than TcB1 in sensitivity and specificity. It is concluded that TcB is a reliable device for monitoring jaundice in Chinese full-term newborns. Peak level of jaundice occurred at the third to fourth day of age. The incidence of hyperbilirubinemia in Chinese infants has decreased, for reasons which need further investigation.

Detection of mutations in the p53 gene in human head and neck carcinomas by single strand conformation polymorphism analysis

Using the polymerase chain reaction (PCR)-based single strand conformation polymorphism (SSCP) analysis, we have examined the highly conserved regions of the p53 gene in 58 biopsy samples of head and neck tumors. Mutations were found in 13/58 (23%) tumor specimens, but not in 6 normal tissues. Ten of 13 mutations were due to single base changes and the remaining 3 were 1- or 8-base deletion mutants. These mutations were clustered in exons 5 and 7 and resulted in amino acid changes. Our results seem to indicate that mutations in the p53 gene contribute to a significant number of cases of the head and neck tumors including 20% of nasopharyngeal carcinoma biopsies. The relationship of Epstein-Barr virus or human papillomavirus and p53 gene mutations in this group of cancers was also analyzed and discussed.

Atlantoaxial subluxation and syringomyelia in Down syndrome: report of one case

Atlantoaxial instability is a relatively frequent finding in Down syndrome, but syringomyelia is a rare symptom. A four-year-old girl with Down syndrome was noted to have one year history of torticollis and progressive motor deterioration presenting with abnormal gait, ataxia or quadriparesis for the past three months. She was admitted because of acute urinary retention. Physical examination showed distended urinary bladder, hyperreflexia, bilateral ankle clonus and the existence of Babinski's signs. The x-ray films of the cervical spine showed widening between the joint space of atlas and odontoid processes. Magnetic resonance imaging revealed C1-C2 subluxation with syringomyelia. After bladder training and cervical orthosis, the symptoms improved.

Direct stimulation of immediate-early genes by intranuclear insulin in trypsin-treated H35 hepatoma cells

H35 hepatoma cells were treated with trypsin to abolish insulin binding and insulin-stimulated receptor kinase activity. Insulin was, however, internalized by fluid-phase endocytosis in trypsin-treated cells. Furthermore, nuclear accumulation of insulin was similar in control and trypsin-treated hepatoma cells. Northern blot analysis revealed insulin increased g33 and c-fos mRNA concentrations identically in control and trypsin-treated cells but had no effect on beta 2-microglobulin mRNA. Actinomycin D treatment prior to or after insulin addition demonstrated that insulin increased gene transcription and had no effect on mRNA degradation. These studies suggest that the accumulation of intact insulin in cell nuclei may be directly involved in the increased transcription of immediate-early genes.

The adenosine analogue N6-L-phenylisopropyladenosine inhibits catecholamine secretion from bovine adrenal medulla cells by inhibiting calcium influx

We reported earlier that adenine nucleotides and adenosine inhibit acetylcholine-induced catecholamine secretion from bovine adrenal medulla chromaffin cells. In this article, we used an adenosine analogue, N6-L-phenylisopropyladenosine (PIA), to study the mechanism underlying inhibition of catecholamine secretion by adenosine. PIA inhibits secretion induced by a nicotinic agonist, 1,1-dimethyl-4-phenylpiperazinium, or by elevated external K+. The half-maximal effect on 1,1-dimethyl-4-phenylpiperazinium-induced secretion occurred at approximately 5 x 10(-5) M. The inhibition is immediate and reversible. Fura-2 measurements of cytosolic free Ca2+ indicate that PIA inhibits Ca2+ elevation caused by stimulation; measurements of 45Ca2+ influx show that PIA inhibits uptake of Ca2+. PIA does not inhibit calcium-evoked secretion from digitonin-permeabilized cells, nor does PIA cause any significant change in the dependence of catecholamine secretion on calcium concentration. These data suggest that inhibition by PIA occurs at the level of the voltage-sensitive calcium channel.

Crystallographic refinement of trichosanthin at 2.6A resolution

The molecule model of trichosanthin has been rebuilt by using the electron density map improved by the solvent flatten and in accordance with the primary structure put forward by Collins. The crystallographic refinement of two trichosanthin molecules (3828 nonhydrogen atoms) in an asymmetric unit has been carried out by means of the restrain least-square procedure and diffraction data to a resolution of 2.6 A. The results are: an R factor 0.223 and the r.m.s. deviation of the bond length = 0.023 A. The new molecular model is in good agreement with the electron density map calculated with the coefficient 2Fo-Fc.

Disulfide-linked and noncovalent dimers of p185HER-2 in human breast carcinoma cells

Enhanced levels of disulfide-linked dimers of the neu oncogene product have been suggested to be associated with the transformed state [Weiner DB, Liu J, Cohen JA, Williams WV, Greene MI: Nature 338:230-231, (1989)]. We, therefore, investigated the properties of the dimeric forms of p185HER-2/neu from the human breast carcinoma cell line, SK-BR-3. We found disulfide-linked dimers as well as noncovalently associated dimers that were detected by cross-linking with bis(sulfosuccinimidyl) suberate (BS3). However, the disulfide-linked dimers did not exist in intact cells, since they were eliminated when the cells were lysed in the presence of the alkylating agent, sodium iodoacetate. Moreover, the disulfide-linked dimeric molecules were not the activated form of p185HER-2 since they incorporated about the same level of phosphate in an in vitro kinase reaction as the monomeric molecules. In contrast, the noncovalent dimers appeared to be present on the surface of intact cells and were phosphorylated at levels at least tenfold higher than monomers in an in vitro kinase reaction.

Presence of Na+/Ca2+ exchange activity and its role in regulation of intracellular calcium concentration in bovine adrenal chromaffin cells

The presence of a Na+/Ca2+ exchanger in bovine adrenal chromaffin cells was demonstrated by measuring the efflux of 45Ca2+ which had been preloaded into cells by a brief depolarization. The efflux of 45Ca2+ was dependent on extracellular Na+ (Na+o); 45Ca2+ efflux was significantly decreased by replacing Na+o with N-methylglucamine (NMG), or Li+. Replacement of Na+o by NMG increased the resting intracellular Ca2+ concentration ([Ca2+]i) of freshly isolated chromaffin cells. This could be reversed by adding Na+, suggesting that Na+/Ca2+ exchanger activity was involved in maintaining [Ca2+]i at its resting level. The initial rate of Na(+)-dependent [Ca2+]i recovery after Ca2+ loading by depolarization was dependent on the level of [Ca2+]i. There was an apparent linear relationship between the activity of the Na+/Ca2+ exchanger and [Ca2+]i both in the presence and absence of Na+o. When cells were treated with other stimuli, including 10 microM DMPP or 40 mM caffeine, the ability of the stimulated cells to decrease [Ca2+]i was significantly reduced upon replacing Na+o with NMG. Our data show that the Na+/Ca2+ exchanger is one of the major pathways for regulating [Ca2+]i in chromaffin cells in both resting and stimulated states.

Cytogenetic analysis of head and neck carcinomas

Ten primary squamous cell carcinomas (SCC) of the head and neck were evaluated cytogenetically after 10-14 days of in vitro culture. Addition of 3% L-glutamine was essential for consistent epithelial growth of these carcinomas. Outgrowth of cells from tissue explants contained a mixture of chromosomally normal and abnormal cells; the abnormal cells had extensive changes including translocations, marker chromosomes, inversions, deletions, and duplications. In addition, all carcinomas contained cells with pulverization and double minute chromosomes (dmin). Chromosomes 11, 13, and 14 had "hotspots" of rearrangements.

Physical and biological properties of fluorescent dansylated bile salt derivatives: the role of steroid ring hydroxylation

The hydroxyl groups of bile salts play a major role in determining their physical properties and physiologic behavior. To date, no fluorescent bile salt derivatives have been prepared which permit evaluation of the functional role of the steroid ring. We have prepared five fluorescent cholanoyl derivatives using a dansyl-ethylene diamine precursor linked to the sulfonyl group of taurine; N-(5-dimethylamino-1-naphthalenesulfonyl)-N'-(2-aminoethanesulf onyl)- ethylenediamine. The fluorescent dansyl-taurine was conjugated to the carboxyl group of free bile acids, enabling the labeling of the series: dehydrocholate, ursodeoxycholate, cholate, chenodeoxycholate and deoxycholate. Despite a systematic hydrophobic shift compared with the native bile salts (aqueous solubility and water:octanol partitioning), the influence of steroid ring hydroxylation was retained, with the dehydrocholate and cholate derivatives more water soluble than the dihydroxy derivatives. Similarly, the sequence of HPLC mobilities, reflecting relative hydrophilicity, was identical in the dansyl-taurine derivatives and the native taurine-conjugated bile salts. Cellular uptake of all five steroid derivatives was rapid, and partial inhibition of [3H]taurocholate uptake was observed in isolated hepatocytes. Rates of biliary excretion of the dansylated derivatives by the isolated perfused rat liver correlated closely with hydrophilicity. Collectively, these findings indicate that the influence of the hydroxyl groups is retained in this series of dansylated steroids, and that hydroxylation is a key determinant of their hepatocellular transport and biliary excretion. These fluorescent bile salt derivatives may thus serve as unique probes for investigating structure-function relationships in hepatic processing of steroid-based compounds.

The epidemiology of diarrhoeal diseases in southeastern China

In a community survey of 19,410 people for 12 months in southeastern China (Fujian Province), the overall annual incidence rate of diarrhoea was 729.9 episodes/1,000 population. The incidence varied with different age groups; children aged under five years had the highest rate, 2.25 episodes per child per year. A bacterial pathogen was isolated from 883 cases (44.03%), and 147 (14.76%) strains from 996 healthy controls. Enterotoxigenic Escherichia coli, enteropathogenic E. coli, and Shigella species were the most frequently isolated bacterial pathogens. Isolation was highest during the hot summer months. The investigation showed that the diarrhoea incidence was related to the status of economy, education, healthy, hygiene, food, and water.

Precision displacement measurement by active laser heterodyne interferometry

We demonstrate an active laser heterodyne interferometer which can automatically compensate environmental disturbances and is capable of precision displacement measurement. Two Zeeman He-Ne lasers were employed. Laser II was used as the light source to stabilize the interferometer by using a piezomirror in a feedback loop. The hetereodyne signal of the two lasers was used to directly calibrate mirror displacement, with the wavelength of laser I tuned to compensate change in the interference signal due to displacement only. Separation of the contributions to the interference signal from displacement and external disturbances was accomplished by using polarization optics. This interferometer was used to measure the hysteresis of a piezoelectric transducer (PZT) over a dynamic range of 0.5 microm with a resolution of +/-0.8 nm.

Effects of deoxycholate on the transepithelial transport of sucrose and horseradish peroxidase in filter-grown Madin-Darby canine kidney (MDCK) cells

Madin-Darby canine kidney (MDCK) epithelial cells grown on microporous polycarbonate filters were used as a model system to investigate the mechanisms of enhancement by deoxycholate in the transepithelial transport of horseradish peroxidase (HRP) and 14C-sucrose. Deoxycholate at 0.025% had no effect on the transepithelial electrical resistance (TEER); a fivefold enhancement on the transepithelial transport of HRP, but not on that of 14C-sucrose, was observed. Deoxycholate at 0.05% induced a reversible decrease of TEER; a 2- and 50-fold enhancement on the transepithelial transport of 14C-sucrose and HRP, respectively, was observed. At 0.1%, deoxycholate induced an irreversible decrease in TEER and the epithelial barrier in the cell monolayer was completely eliminated. A 3.3-fold increase in cellular uptake in HRP, but not in 14C-sucrose, was also observed in the presence of 0.025% deoxycholate. The increase in cellular uptake was abolished when HRP was conjugated to polylysine. These results suggest that deoxycholate can increase the transepithelial transport by at least two different mechanisms, i.e., a transcellular pathway, possibly due to the enhancement of cellular uptake of selective molecules, and a nonselective paracellular pathway, due to the loosening of tight junctions by deoxycholate at higher concentrations.

Protease-like sequence in hepatitis B virus core antigen is not involved in the cleavage processes of core protein in Escherichia coli

A DNA fragment, coding for hepatitis core antigen (HBcAg), was amplified by polymerase chain reaction and inserted into a lambda PL promoter-derived expression vector. The recombinant plasmid was transformed into Escherichia coli and proteins produced after heat induction were analyzed. In addition to the 21 kDa HBcAg protein, several smaller related polypeptides, particularly one of 17 kDa in size, were also detected with rabbit anti-HBcAg antiserum. Whether the protease-like sequence of core protein involved in the self-cleavage process to form the 17 kDa polypeptide was investigated by a deletion experiment. Our results with a mutant in which 7 amino acids of the conserved protease-like region in the core protein have been deleted suggest that the cleavage does not depend on the presence of these protease-like sequence. In addition, the core protein synthesized from in vitro translation reaction was not cleaved. Core particles from E. coli lysate were purified by sucrose and cesium chloride density gradient centrifugations and subsequently treated with 0.2% of SDS and 0.2% of beta-mecaptoethanol. Immunoblotting analysis, however, did not reveal any conversion of the 21 kDa protein to smaller ones. In conclusion, our results suggest that the protease-like domain at the N-terminus of the core protein does not contain intrinsic autocleavage activity, nor could the HBcAg be converted to smaller antigens by detergent treatment.

Caffeine-sensitive calcium stores in bovine adrenal chromaffin cells

Caffeine was used to study the intracellular Ca2+ pools of bovine chromaffin cells. Its effects on cytosolic Ca2+ concentration ([Ca2+]i) were examined using fura-2. Caffeine caused a transient increase in [Ca2+]i in the presence or absence of extracellular Ca2+. In the former case, the caffeine-induced [Ca2+]i increase was higher and stayed above the basal value for several minutes. In the latter case, the [Ca2+]i rise was lower and fell to the basal level within 1 min. These results suggest that caffeine increases [Ca2+]i by causing both Ca2+ influx and Ca2+ release from intracellular pools. In the absence of extracellular Ca2+, ionomycin but not caffeine caused a further increase in [Ca2+]i in cells that had been treated with caffeine. Apparently there are at least two intracellular Ca2+ pools, only one of which is sensitive to caffeine. The caffeine-induced [Ca2+]i rise became smaller when the cells were pretreated with the inositol trisphosphate-generating agonists, methacholine and bradykinin. In addition, methacholine was unable to initiate a [Ca2+]i transient after the cells had been treated with caffeine. The results indicate that the caffeine-sensitive Ca2+ pools overlap with the inositol trisphosphate-sensitive pool and that the size of the latter pool is smaller than that of the former. The caffeine-sensitive Ca2+ pools were refilled after high K+ treatment, which suggests that the caffeine-sensitive Ca2+ pools may be important in buffering the cytosolic Ca2+. The effect of caffeine on [Ca2+]i is not due to inhibition of phosphodiesterase. Our results support a Ca2+ entry model in which depletion of intracellular Ca2+ pools controls the rate of Ca2+ entry across the plasma membrane.

New crystalline forms of neuraminidase of type B human influenza virus

New crystalline forms of tetrameric neuraminidase heads from two strains (B/Lee/40 and B/mem/89) of type B human influenza virus were obtained and the crystals diffracted using X-rays to 2.5 A resolution without lattice disorder. The new B/Lee/40 crystalline form is tetragonal, space group P42(1)2, with unit cell dimensions a = 123.8 A, c = 71.8 A. The B/mem/89 crystalline form is also tetragonal, space group I422, with unit cell dimensions a = 122.9 A, c = 164.4 A. There is one neuraminidase monomer per asymmetric unit in both forms.