Primary cutaneous cryptococcosis following trauma of the right forearm

A 62-year-old woman with sarcoidosis II, status post systemic steroid treatment, developed an inflammatory, infiltrative skin lesion in the area of a traumatic haematoma of the right forearm. The clinical appearance at first corresponded to bullous erysipelas. Antibiotic therapy, which was instituted immediately, proved to be ineffective. A microbiological swab revealed infection with Cryptococcus neoformans. A systemic cryptococcosis could be excluded. Therapy with 200 mg itraconazole twice daily resulted in a prompt improvement.

Refinement of the Van der Woude gene location and construction of a 3.5-Mb YAC contig and STS map spanning the critical region in 1q32-q41

Van der Woude syndrome (VWS) is the most frequent form of syndromic clefting. Linkage analysis has localized the gene between D1S245 and D1S414, an interval of 4.1 cM with the following order of loci: centromere-D1S245/D1S471-D1S491-D1S205-D1S414 -telomere. A microdeletion around D1S205 aided in narrowing the critical region to D1S491-D1S414 by heterozygosity testing. In this study, the location was refined by detection of a recombinant with D1S205 in a new family, indicating that VWS lies between D1S491 and D1S205, a 1.6-cM interval. A roughly 3.5-Mb YAC contig was built from D1S245 through D1S414, encompassing the interval D1S491-D1S205 in level 1 or level 2 paths. Clones were assembled by sequence tagged site (STS) content using the five polymorphic markers from above, four novel STSs identified from YAC ends, and a new STS derived from probe CRI-L461 (D1S70). D1S70 was assigned to the critical region. One single YAC, yCEPH785B2, contains both flanking STSs (D1S491, D1S205). STS content mapping suggests neither chimerism nor deletion of yCEPH785B2 but does suggest that the maximum size of the critical region is approximately 850 kb. All STSs were tested for their presence on a somatic cell hybrid containing the microdeleted chromosome 1 as the sole human chromosome 1 component. Both the proximal and distal ends of the microdeletion mapped to the 850-kb YAC, yCEPH785B2. Therefore, the microdeletion overlapped the critical region, confirming the genetic recombinant data.

Isolation of Bartonella quintana from an HIV-positive patient with bacillary angiomatosis

Bartonella quintana was grown from a lysis-centrifugation blood culture of an HIV-positive man who presented with lesions of bacillary angiomatosis in skin and bones. The isolate was identified by sodium dodecylsulfate-polyacrylamide gel electrophoresis, 16S rRNA gene sequencing, and amplification of the enterobacterial repetitive intergenic consensus sequences.

Regulation of cell wall invertase by a proteinaceous inhibitor

Suspension-cultured tobacco cells express a cell wall invertase (CWI) and a proteinaceous invertase inhibitor. Both proteins have been purified and characterized. A CWI cDNA clone has been isolated. The N-terminal protein sequence of the inhibitor has been determined showing high similarity with the N-terminal sequence of a tomato invertase inhibitor. A polyclonal antiserum has been raised against the denatured inhibitor protein. The observed changes of CWI activity during cell culture are partially the result of changes in gene expression, however, evidence has accumulated for further regulation by the inhibitor protein. In vivo regulation of CWI by the inhibitor is likely for the following reasons: (1) CWI inhibition is dependent on pH within the range relevant for the apoplasmic space, (2) divalent cations in the millimolar range affect CWI inhibition, (3) substrate protects CWI (but not vacuolar invertase) against inhibition, (4) CWI and inhibitor are co-expressed and co-localized in the apoplasmic space, (5) addition of inhibitor to intact cells causes substrate-protectable inhibition of CWI, (6) an in situ formation of tight complexes between CWI and inhibitor upon starvation of cells could be demonstrated. The results indicate that suspension-cultured tobacco cells are a suitable system to study the effects of an invertase inhibitor on CWI.

Sucrose protects cell wall invertase but not vacuolar invertase against proteinaceous inhibitors

Vacuolar (VI) and cell wall invertases (CWI) of higher plants can be inactivated in vitro and, possibly, in vivo by proteinaceous inhibitors. The respective mechanisms have not yet been compared. Therefore, partially purified CWI from transformed tobacco cells and VI from tomato fruit were preincubated with invertase-inhibitor fractions isolated from the same tissues. Both inhibitors were able to inhibit both invertases. However, VI was fully inhibited within less than 1 min by both inhibitors, whereas inactivation of CWI was much slower. Furthermore, CWI, but not VI, was strongly protected against inhibition by sucrose. A polyclonal antiserum directed against the tobacco inhibitor (I(NT)) cross-reacted with a 19 kDa polypeptide in the partially purified tomato inhibitor (I(LE)) fraction. The results indicate that I(NT) and I(LE)have similar structural properties, whereas the mechanism of inactivation is clearly different for CWI and VI.

[An optimized filter system for eliminating 50 Hz interference from high resolution ECG]

A 50/60 Hz notch filter system was designed to eliminate powerline interferences from the high-resolution ECG. This special filter causes only minimal distortions of the power spectra and thus permits us to filter high-resolution ECG's without any appreciable changes in the frequency distribution of the original signal. Since the filter is based on an integer coefficient filter technique, the calculation time is relatively short, and the programming effort comparatively low. Three different automatically selected transfer functions ensure that an optimal filtered signal is obtained despite variations in the value of the interference.

Phase effects in masking related to dispersion in the inner ear. II. Masking period patterns of short targets

This article investigates how the amplitude and phase characteristics of the inner ear influence the spectrotemporal representation of harmonic complex sounds. Five experiments are reported, in each of which three sets of maskers are compared that differ only in their phase spectra. The amplitude spectra of the complexes were flat and the phase choices were (a) zero phase, (b) Schroeder phases with a positive sign, and (c) Schroeder phases with a negative sign. In the first four experiments, the spectra contained all harmonics between 200 and 2000 Hz. In experiments 1 and 2, the signal frequency was fixed at 1100 Hz and the fundamental frequency of the maskers was varied. In experiments 3 and 4, the fundamental frequency of the maskers was fixed and the signal frequency varied between 200 and 2000 Hz. In experiments 1 and 3, the signal duration was long compared to the period of the maskers. In experiments 2 and 4, the signal duration was only 5 ms and thresholds were determined for different time points within the masker's period. The results show a strong correlation between the minima of the short signal's thresholds and the threshold of the long signal. In experiment 5, the spectral extent of the masker was shifted to values one octave lower (100 to 1000 Hz) or one or two octaves higher (400 to 4000 Hz and 800 to 8000 Hz, respectively). For each spectral region, masked thresholds of a long signal were obtained for three values of the fundamental frequency. In all five experiments the thresholds depended very much on the specific phase choices with differences of up to 25 dB. The masker with a negative Schroeder phase always led to the highest thresholds. The thresholds of the masker with a positive Schroeder phase, on the other hand, were for a wide range of parameters lower than the thresholds for the zero-phase masker. These phase effects are most likely caused by the phase characteristic of the basilar-membrane filter, which affects the flat envelopes of the two Schroeder-phase maskers in a very different way. For an appropriate choice of parameters, one of the two becomes even more strongly modulated than the zero-phase complex. This latter observation imposes some restrictions on the second derivative (curvature) of the phase-versus-frequency relation for the auditory filters.

Microsatellite-based fine mapping of the Van der Woude syndrome locus to an interval of 4.1 cM between D1S245 and D1S414

Van der Woude syndrome (VWS) is an autosomal dominant craniofacial disorder characterized by lip pits, clefting of the primary or secondary palate, and hypodontia. The gene has been localized, by RFLP-based linkage studies, to region 1q32-41 between D1S65-REN and D1S65-TGFB2. In this study we report the linkage analysis of 15 VWS families, using 18 microsatellite markers. Multipoint linkage analysis places the gene, with significant odds of 2,344:1, in a 4.1-cM interval flanked by D1S245 and D1S414. Two-point linkage analysis demonstrates close linkage of VWS with D1S205 (lod score [Z] = 24.41 at theta = .00) and with D1S491 (Z = 21.23 at theta = .00). The results revise the previous assignment of the VWS locus and show in an integrated map of the region 1q32-42 that the VWS gene resides more distally than previously suggested. When information about heterozygosity of the closely linked marker D1S491 in the affected members of the VWS family with a microdeletion is taken into account, the VWS critical region can be further narrowed, to the 3.6-cM interval between D1S491 and D1S414.

Evidence for a microdeletion in 1q32-41 involving the gene responsible for Van der Woude syndrome

Van der Woude syndrome (VWS) is an autosomal dominant craniofacial disorder representing the most frequent form of syndromic cleft lip and palate. Other characteristic features are pits of the lower lip and hypodontia. The gene shows high penetrance and seems to play an important role in orofacial development determined by the tissues involved and their formation during different periods of craniofacial development. Although most individuals affected with VWS show Mendelian inheritance, one patient with a macroscopic deletion and multiple malformations including two primary features of VWS has been described in the literature, indicating hemizygosity is compatible with the VWS phenotype. We report here the allelic loss of a stable and highly polymorphic microsatellite (D1S205) from region 1q32-41 in one family with VWS. Classical manifestations of the syndrome superimposed on developmental delay in all affected members of the family, the absence of cytogenetic abnormalities, the reproducibility of the null allele with a new set of primers and close linkage of this marker in a total of 15 VWS families provide strong evidence that the first microdeletion involving the gene for VWS has been identified. Assuming 1 Mb of DNA per cM of genetic distance, the upper bound of the deletion size would amount to 4 Mb.

Linkage of Van der Woude syndrome (VWS) to REN and exclusion of the candidate gene TGFB2 from the disease locus in a large pedigree

Van der Woude syndrome (VWS) is an autosomal dominant disorder associated with one or more of the following features: clefting of the primary or secondary palate, hypodontia or lower lip pits. It has been estimated to account for 2% of all cases of cleft lip and palate. VWS is one of the rare disorders in which clefting of the primary and secondary palate may be seen to segregate as components associated with the same gene. Because of its autosomal dominant inheritance, VWS is readily accessable to linkage analysis as a preliminary step in the identification of the molecular abnormality underlying the clefting effect in the primary and secondary palate. A reported linkage between REN and VWS has promoted us to use pHRnX3.6 (REN) and several markers surrounding REN for a linkage analysis in a large Swiss family. In a second step, linkage analysis was performed to study restriction fragment length polymorphisms for the candidate gene TGFB2 and other loci recently mapped to the candidate region 1q32-1q41. Evidence for linkage (theta = 0.00, lod score = 3.01) between REN and VWS could be confirmed in this pedigree. TGFB2 demonstrated recombination with the disease locus and is unlikely to be causative in VWS. The results of a multipoint linkage analysis showed that VWS was flanked by D1S65 and TGFB2 at a maximum location score of 20.3.

The role of GM-CSF in the treatment of acute myeloid leukemia

After a first study showed that GM-CSF following chemotherapy effectively accelerated neutrophil recovery and reduced early mortality in high risk patients with AML, a second study was begun in which GM-CSF was applied preceding chemotherapy and continuing until neutrophil recovery in the initial 5 chemotherapy courses for patients with newly diagnosed AML. The CR rate in patients of 16-75 (median 50) years was 75% in GM-CSF patients and 84% in controls. GM-CSF patients showed a trend to more frequent rapid blast clearance and fewer persistent leukemias and a significantly superior remission duration as of this update two-and-a-half years after the study started. It should be shown later by this study whether GM-CSF multiple course priming and longterm administration adds to the cure rate of patients with AML.

[Periosteal and endosteal blood supply of the human fibula and its clinical importance]

The angioarchitecture of the human fibula was investigated by anatomical dissection. The main artery of the periosteal and endosteal blood supply is the arteria fibularis. The proximal part of the facies lateralis is additionally nourished by a well-built branch of the arteria tibialis anterior. The periosteal branches of the arteria fibularis are most voluminous on the dorsal side in the middle of the fibula. Small plates take care of these branches. For an additional revascularization the well-built branch of the arteria tibialis anterior is proposed. The best anatomical region for a vascularized fibular transfer is at an average of 20% up to 75% of the fibular length.

Comparison of hand preference in trainable mentally handicapped and nonhandicapped children

Hand preference was compared in 22 trainable mentally handicapped and 22 nonhandicapped children (Mage 78.00 mo.). Significant differences were found, showing the nonhandicapped group had a stronger preference when presented 10 hand-choice items from The Harris Tests of Lateral Dominance. In addition, stronger lefthandedness characterized the handicapped group, supporting previous research.

[Special milk formulas in the dietary treatment of diarrhea in infants (author's transl)]

233 infants with diarrhea were dietetically treated with 10 different industrially processed milk products, so called "Heilnahrungen" (healing-food) which were available in a fluid (ready to feed) or powdered-form. The curative effect of products containing 1-2% lactose was better than that of the lactose-free ones. There are no objections to the addition of 1-2% fat. The addition of MCT was not necessary. Infants on lactose containing formulas showed the quickest normalization of stools with only a few relapses. This benefit is possibly due to feeding the products in a non diluted form.