Human nidogen gene: structural and functional characterization of the 5'-flanking region

Nidogen is a sulfated multifunctional glycoprotein present in basement membranes. In this study, we have cloned the 5'-flanking region of the human nidogen gene. Initially, an approximately 35-kb DNA clone (NCos4) was isolated from a human cosmid genomic library. Southern hybridization of EcoRI-digested NCos4 allowed isolation of a 3.7-kb fragment, which was shown to contain a portion of intron 1, the entire exon 1, and approximately 0.9 kb of 5'-flanking sequences of the nidogen gene. Nucleotide sequencing of the 5'-flanking DNA revealed the presence of two canonic CCAAT consensus sequences in the antisense strand and a potential variant of the TATA motif, TATTT, in the sense strand. One putative AP-2 and six putative SP1 binding sites were also present. To test the functional promoter activity of the 5'-flanking genomic DNA, two nidogen promoter/CAT reporter gene constructs, with the promoter segment spanning from -864 to -1 and from -534 to -1, respectively, were developed and analyzed in transient transfections of human and mouse cell cultures. Both constructs showed clearly detectable promoter activity, and the activity of the larger construct could be up-regulated by 12-O-tetradecanoyl phorbol 13-acetate up to 2.5 times. The results indicate that the nidogen promoter/CAT gene constructs developed in this study provide a means to examine the transcriptional regulation of nidogen gene expression in human diseases of the basement membrane zone.

Use of whole bowel irrigation in an infant following iron overdose

An 11-month-old, 11-kg infant presented to the emergency department after ingesting 130 to 150 mg/kg of elemental iron. Emesis was induced twice and the child was lavaged throughout a 4-hour period with some tablet return. An abdominal radiograph after gastrointestinal decontamination showed at least 16 whole iron tablets remaining in the stomach. Serum iron drawn 2 hours postingestion was 46.7 mumol/L. Blood glucose was 7.7 mmol/L and white blood count was 21,800 mm3. Despite a second lavage 8 hours postingestion, a large number of whole tablets were visualized in the stomach per radiograph. Whole bowel irrigation with polyethylene glycol electrolyte lavage solution (Golytely, Braintree Laboratories, Inc, Braintree, MA) was begun via nasogastric tube 14 hours after the ingestion. Serial abdominal radiographs showed tablet movement out of the stomach within 4 hours after initiating whole bowel irrigation. This case demonstrates the safety and efficacy of WBI in an infant when conventional gastrointestinal decontamination has failed.

Hurler's disease with diastematomyelia

A case of Hurler's disease is reported in a child with a gibbous deformity of the lumbar vertebrae L1/L2 and a localized diastematomyelia of the spinal cord at L1/L3. The association of an enzyme disorder affecting connective tissue with spinal cord dysraphism has not been reported before, and may be fortuitous. However, as each condition is rare, the occurrence of both gibbous deformity due to Hurler's and diastematomyelia in the same child, makes it unlikely to be a chance association. We suggest that defective neurulation in this case may be related to mesodermal damage associated with mucopolysaccharidosis.

Calcium antagonists in the treatment of Tourette's disorder

Two patients with Tourette's disorder were treated with calcium antagonists. Verapamil and nifedipine produced positive responses, and diltiazem produced no response. Given the negative side effects of the current drugs for this disorder, the authors suggest further study of calcium antagonists.

Drinking in bars: an observational study of companion status and drinking behavior

The drinking behavior of 329 patrons was observed in three public drinking settings in Boston. Variations in drinking behavior and patron characteristics at each site were noted. Group setting was significantly related to duration of stay among males in two sites. Duration of stay was related to level of consumption in all sites for men and women. The relationship between companion status and drinking behavior varied by site and sex of patron.

Electrocardiographic effects of tranylcypromine vs. amitriptyline

The authors compared ECG changes during the course of treatment with a tricyclic antidepressant (amitriptyline) or a monoamine oxidase inhibitor (tranylcypromine) in 22 adult psychiatric patients. Amitriptyline-treated patients showed increased heart rate, PR, QRS, and QTc intervals. Tranylcypromine-treated patients showed no significant changes in ECG parameters. The clinical significance of the differing pattern of ECG effects for tricyclic antidepressants and monoamine oxidase inhibitors is discussed.